Lung torsion after pulmonary resection is a rare but potentially fatal complication. It most commonly occurs in the right middle lobe following right-sided resections. Left lower lobe torsion after left upper lobectomy is considerably less common than right middle lobe torsion. The patient underwent left upper lobectomy for a typical carcinoid tumor. During postoperative follow-up, serial chest radiographs demonstrated progressive consolidation of the left lower lobe; subsequent bronchoscopy revealed near-complete obstruction of the left lower lobe bronchus. Contrast-enhanced computed tomography demonstrated interruption of the left pulmonary arterial continuity, raising suspicion of left lower lobe torsion. Surgical exploration confirmed torsion with irreversible parenchymal injury, necessitating completion pneumonectomy. We present this rare and challenging clinical scenario in the context of the existing literature.
Intrathoracic extramedullary haematopoiesis (IEMH) is a rare manifestation of chronic haemolytic anaemia that typically presents as bilateral paraspinal masses in the posterior mediastinum and may be radiologically indistinguishable from neoplastic lesions. Optimal management, particularly the role of thoracic surgery, remains controversial. A 34-year-old woman with a long-standing history of haemolytic anaemia with spherocytosis presented with acute severe right-sided back pain. Chest computed tomography revealed splenomegaly and a large, well-circumscribed right paraspinal mass, radiologically indicative of either a neurogenic tumour or IEMH. Because of the high risk of intraoperative haemorrhage, immediate thoracic resection was deferred. Despite subsequent immunosuppressive therapy and localised radiotherapy, the paraspinal mass and symptomatic haemolysis remained unchanged. Consequently, laparoscopic splenectomy was conducted for definitive haematological management after preoperative immunisation against Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b. Postoperatively, the patient experienced progressive clinical improvement with normalisation of haemoglobin levels and complete resolution of back pain. Serial imaging over an 8-year period demonstrated substantial involution of the intrathoracic mass following haematological stabilisation, without any direct thoracic surgical intervention. This case highlights that optimisation of the underlying haematological disorder can achieve both symptomatic relief and radiological regression of IEMH. Careful radiological assessment and a multidisciplinary approach, with priority given to the optimisation of the underlying haematological condition, are essential to avoid unnecessary invasive procedures.
The Vasoactive-Inotropic Score (VIS) quantifies pharmacological hemodynamic support after pediatric cardiac surgery, but bedside calculation requires multi-step manual arithmetic. We describe the development and preliminary evaluation of VISCalc, a low-cost web-based VIS calculator. VISCalc was developed in sequential phases in a pediatric cardiac intensive care unit in São Paulo, Brazil. Usability was assessed with the System Usability Scale (SUS) among 15 physicians. Arithmetic fidelity was verified in ten retrospective clinical cases independently calculated by three blinded evaluators and in 12 predefined synthetic cases covering all six VIS drugs. The mean SUS score was 73.3 ± 8.5, indicating good usability. VISCalc returned the correct VIS in all ten clinical cases and 12 synthetic cases, whereas 29/30 manual calculations (96.7
Regional data on valve-sparing root replacement (VSRR) outcomes within emerging surgical programs remain limited. We report our institutional experience using the David I procedure from a tertiary care center in South India. We retrospectively evaluated 25 consecutive patients who underwent David I VSRR between January 2017 and December 2022. Endpoints included 30-day mortality, overall survival, and valve durability [defined as freedom from ≥ moderate aortic regurgitation (AR)]. The cohort (median age 50 years, 72
Women remain underrepresented in cardiothoracic and vascular surgery, and disparities in academic authorship reflect broader inequities in career advancement and leadership. There is a paucity of data examining gender-based authorship trends in Indian cardiothoracic and vascular surgical literature. We aimed to analyse the temporal trends in female authorship in the Indian Journal of Thoracic and Cardiovascular Surgery (IJTC). We conducted a retrospective bibliometric analysis of articles published in the IJTC between January 1, 2018, and December 31, 2025, and indexed in PubMed at the time of data retrieval. Article metadata were reviewed to determine author gender, authorship position, publication type, and temporal trends. Female authorship was assessed across any authorship, first authorship, and senior (last) authorship positions. A total of 1439 publications comprising 5254 identifiable authorship instances were analysed. Female authors accounted for 838 authorship instances (15.9
