Indian Journal of Thoracic and Cardiovascular Surgery (Indian J Thorac Cardiovasc Surg )

Publisher: Springer Verlag


This Publication is the official organ of the Indian Association of Cardiovscular- Thoracic Surgeons. Edited, printed and published quarterly.

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    Indian Journal of Thoracic and Cardiovascular Surgery website
  • Other titles
    Indian journal of thoracic and cardiovascular surgery (Online)
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    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

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Springer Verlag

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Publications in this journal

  • Indian Journal of Thoracic and Cardiovascular Surgery 09/2014;
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    ABSTRACT: Background Atrioventricular Valve Regurgitation (AVVR) is a risk factor for increased mortality in patients with single ventricular physiology. We postulate that by offloading the blood volume from the single ventricle, AVVR would improve without valvuloplasty. Objective We aimed to determine risk factors associated with AVVR and whether a Bidirectional Cavopulmonary Anastomosis (BCPA) alone would improve AVVR without valvuloplasty in our cohort of patients. Material and methods A retrospective review of 213 consecutive patients who underwent BCPA between January 2000 to August 2010 was conducted. Eighty patients with AVVR without valvuloplasty were analyzed. Eighty-nine patients required palliation prior to the BCPA. The median age and weight at surgery were 3 years +/−4.4 and 11.2 kg +/−11.4 respectively. 2D Echocardiography was used to quantify the degree of AVVR pre and postoperatively. Significant (moderate and severe) AVVR before BCPA was noted in 29 out of 213 patients (13.6 %). The risk factors associated with AVVR i.e. type of cardiac diagnosis, systemic ventricle, palliation prior to BCPA and age at BCPA were analyzed. Result and conclusion The overall mortality was 5.2 %. The operative mortality was significantly lower in patients operated between 2006 and 2010 as compared to between 2000 and 2005 (0.9 % versus 7.1 %) (p = 0.024). AVVR was significantly higher in patients who had right ventricle as systemic ventricle (p = 0.032) and unbalanced atrioventricular canal (p < 0.05). In the immediate postoperative period, presence of moderate AVVR improved (p < 0.05) from 21.3 to 8.8 %. However at mean follow up of 3.7+/−2.8 years, 12.5 % patients presented with moderate AVVR. In conclusion, the BCPA significantly offloaded the single ventricle and improved AVVR in patients with moderate regurgitation. However, improvement did not sustain at longer duration of follow up.
    Indian Journal of Thoracic and Cardiovascular Surgery 02/2014;
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2014;
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    ABSTRACT: Endodermal cysts, also known as enteric cysts, enterogenous cysts, neuroenteric cysts, gastrocystoma, teratomatous, or archenteric cysts, are derived from endoderm in the gastrointestinal (GI) or rarely from the respiratory tract. These are the result of faulty separation of ectodermal and endodermal layers leading to inclusion of endodermal tissues and cyst formation [1]. The developmental anomalies can be separated into bronchopulmonary (from the lung bud), vascular, or combined (including lung and vascular elements) [2]. The lung bud anomalies include agenesis, atresia, congenital lobar emphysema, congenital cystic adenomatoid malformation (CCAM), bronchogenic cyst (BC), pulmonary sequestration, tracheal bronchus (pig trachea), or accessory cardiac bronchus [2]. BC is the common anomaly of the tracheobronchial bud. The common site is the mediastinum but tracheobronchial tree and intrapulmonary origin have been reported. Other rare origin sites included pericardial tissue
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2014; 30(2).
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    ABSTRACT: We describe a new, simple technique for tunneling of reversed saphenous vein graft to prevent its kinking and twisting thereby avoiding early graft failure during peripheral vascular bypass procedures. The technique is based on the principle of a temporary rigid tube outside acting as tunnel for the delicate, compressible reversed saphenous vein grafts in getting the proper lie without twists and kinks.
    Indian Journal of Thoracic and Cardiovascular Surgery 12/2013; 29(4).
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    Indian Journal of Thoracic and Cardiovascular Surgery 12/2013;
  • Indian Journal of Thoracic and Cardiovascular Surgery 11/2013;
  • Source
    Indian Journal of Thoracic and Cardiovascular Surgery 03/2013; 29(1).
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    ABSTRACT: Background Perimembranous and sub arterial Ventricular Septal Defects (VSD) are associated with Aortic Regurgitation (AR) in 5 % of patients. More than mild AR needs additional valve intervention during VSD closure. Feasibility of aortic valve repair and its superior results over aortic valve replacement have been documented well. The purpose of this study is to present our initial experience in aortic valve repair in young children with aortic regurgitation. Materials and methods Fourteen out of thirty-one consecutive VSD closures had AR (45.16 %) and six of them (19.35 %) needed intervention. The median age and weight were 8.1 years and 18.7 Kg. The VSD was perimembranous in 5 and sub arterial in 1. The predominant pathology was leaflet prolapse in 5 (right coronary cusp-3, Non coronary cusp-1 and both coronary cusps-1) Results Five had successful aortic valve repair and one underwent aortic valve replacement after a failed valve repair. The technique of repair consisted of commissural placation with cusp shortening, resuspension and bicuspidisation. There were no deaths. Follow-up was 100 % complete at a median of 6 months. AR was trivial in 2, and mild in 3. All are in NYHA class I. Patient with mechanical valve had major anticoagulation-related intra-cerebral bleed needing neurosurgical intervention. Conclusion Early intervention for VSD would possibly prevent aortic valve disease. Aortic valve repair is the procedure of choice in young patients with VSD-AR syndrome and can be performed with low risk, and the freedom from valve-related morbidity and mortality is excellent. Valve repair also avoids anticoagulation related complications.
    Indian Journal of Thoracic and Cardiovascular Surgery 03/2013; 29:1-4.
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    ABSTRACT: Objective This study was carried out to evaluate effect of low volume normal frequency ventilation during Cardiopulmonary Bypass (CPB) on immediate postoperative respiratory outcome in patients undergoing elective open heart surgeries. Background Lung deflation during CPB is considered as major cause of postoperative pulmonary dysfunction. Various methods of ventilation had been tried during CPB to prevent postoperative lung dysfunction. As yet, little information is available comparing low volume normal frequency ventilation with no ventilation during CPB. Patients and Methods Thirty six patients aged 18 years to 65 years were included and randomized into two groups; Group V (n = 18) or Group NV (n = 18). Group V patients were ventilated with a tidal volume of 2 mL kg−1with 100 % oxygen during CPB after aortic clamp placement, and respiratory rate was continued as per pre CPB period. Ventilation was discontinued in NV group after aorta was cross clamped. Normal ventilation was restored in both groups after release of aortic clamp. Results Intraoperative PaO2 and PaCO2 were similar in both groups. The group V patients had improved inspiratory capacity (p = 0.0) in both day 1 (after extubation) and day 2 (24 h after extubation). Extubation was significantly earlier in group V patients (p < 0.05). Conclusion Low volume normal frequency ventilation during cardiopulmonary bypass improves lung mechanics during early postoperative period in patients undergoing open heart surgery.
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2013;
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    ABSTRACT: During the last two decades, there has been a phenomenal rise in the number of patients undergoing early primary repair for congenital heart defects. Repair of these intracardiac defects usually requires open heart surgery that necessitates cardiopulmonary bypass, aortic cross clamping and administered cardiac arrest. To achieve this goal, cardioplegia is administered at predetermined intervals to ensure a quiescent heart and protection of the myocardium from ischaemia at the same time. Cardioplegia administration is usually done in conjunction with hypothermia to decrease the metabolic demands of the arrested heart as hypothermia alone is inferior to the combination of hypothermia and cardioplegia in providing adequate myocardial protection. The types and methods of cardioplegia in use today are as diverse as individual surgeons; and most institutions have over time developed their own preferred myocardial protection techniques that have proven to be safe and effective. Most of the available literature and concepts in pediatric myocardial protection today have been borrowed from observations in adults and ex- vivo and in-vivo animal models. The extrapolation of these concepts to pediatric myocardium is inappropriate as immature myocardium is not simply a “small adult heart”. It has unique differences and susceptibilities. This review provides a synopsis of pediatric myocardial protection including types, mechanisms, composition and comparative features of pediatric cardioplegia solutions currently in use all over the world. As of now, there is no evidence favoring one technique or strategy over the other. Pediatric myocardial protection protocols in general are currently experience based.
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2013; 29(2).
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    ABSTRACT: Carcinosarcoma of esophagus contains both the carcinomatous and sarcomatous elements. These are rare polypoidal malignancies of esophagus. One such case is presented and available literature is reviewed.
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2013; 29(2).
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    ABSTRACT: Primary cardiac tumors are rare and usually benign. The incidence of cardiac lipomas is 8 % of benign cardiac tumors [1]. Several surgical options have been reported to obtain an appropriate operative view because of their poor visualization when the tumors are located in the Left Ventricle (LV). We report a rare case of massive left ventricular lipoma occupying pericardial space. A 23-year-old female had back pain since 6 months. She visited a local orthopedician, who ordered for computed tomography scan of chest and back. Computed tomography showed a large epicardial mass located along the anterior surface of the heart, from the diaphragm level through the aortic arch level. The mass showed an attenuation value identical with that of subcutaneous adipose tissue and contained some areas with high density. The mass was not enhanced by contrast media. Percutaneous biopsy was done, histologic examination of the specimen demonstrated mature adipose tissue. An encapsulated adipose mass weighing 865 g, which originated from the left ventricle anteriorolateral surface without any invasion to the pericardium, was near completely excised, except for a small portion which was encasing obtuse marginal artery. Microscopic examination revealed mature adipose tissue with partial necrosis, confirming the diagnosis of lipoma.
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2013; 29(2).
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2013; 29(4).
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    ABSTRACT: Objective The aim of this study was to retrospectively evaluate the risk factors for developing Nosocomial Infections (NI) after on-pumpCoronary Artery Bypass Grafting (CABG). Methods Study population included 424 patients, operated between January 2010 and December 2010 who underwent a CABG or CABG and valve procedure. The study population was divided into two groups based on the presence or absence of NI. Univariate and multivariate analysis of NI predictors was conducted. Results Of the 424 patients operated, 65(15.3 %) developed a NI. Cultures from the respiratory tract, urinary tract, wound site and blood were analysed. Risk factors for nosocomial infection found significant in our study weretransfusion of blood products, presence of diabetes mellitus, renal dysfunction, longer cardiopulmonary and aortic cross clamp times. Conclusions Optimal control of preoperative risk factors and blood conservation strategies can help in reducing the risk of postoperative nosocomial infections among patients undergoing on-pump CABG.
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2013; 29(2).
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    ABSTRACT: The authors present the case of a 29-year-old woman with a massive anterior mediastinal tumor who presented with respiratory distress since 1 month. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed via median sternotomy. Resection of the tumor resulted in immediate improvement in the patient’s pulmonary status, and the histopathologic examination revealed thymolipoma. Because thymolipoma can attain enormous dimensions and compress adjacent structures, it should be immediately resected.
    Indian Journal of Thoracic and Cardiovascular Surgery 01/2013; 29(2).