Balram Airan - Academia.edu (original) (raw)
Papers by Balram Airan
Seminars in Thoracic and Cardiovascular Surgery, 2017
Comparison of del Nido and St Thomas cardioplegia solutions in pediatric patients: A prospective ... more Comparison of del Nido and St Thomas cardioplegia solutions in pediatric patients: A prospective randomized clinical trial Running head: Comparison of Delnido and St Thomas cardioplegia
Interactive cardiovascular and thoracic surgery, Jan 11, 2017
The Fontan procedure [total cavopulmonary connection (TCPC)] is the final palliation for patients... more The Fontan procedure [total cavopulmonary connection (TCPC)] is the final palliation for patients with univentricular physiology. We studied differential perfusion ratio and percentage uptake of a radiotracer in different zones of each lung following TCPC. Between July 2015 and June 2017, 45 patients underwent 99mTc macroaggregated albumin lung perfusion scan at a mean follow-up period of 49.3 ± SD 26.1 days following TCPC. Differential perfusion ratio and percentage uptake of the radiotracer in the upper, middle and lower zones of each lung were calculated. Post-foot injection [inferior vena cava (IVC) injection], preferential flow to the lungs was as follows: left lung (n = 13, 30.2%), right lung (n = 13, 30.2%) and uniformly to both lungs (n= 17, 39.6%). Post-arm injection [superior vena cava (SVC) injection], preferential flow to the lungs was as follows: left lung (n = 13, 30.2%), right lung (n = 22, 51.2%) and uniformly to both lungs (n= 8, 18.6%). The middle zone was perfused...
Percutaneous transvenous mitral commissurotomy using Inoue balloon in children less than 12 years
Catheterization and Cardiovascular Diagnosis, 1998
Spontaneous Normalization of Valve Function After Failed Fibrinolytic Therapy for Left-Sided Prosthetic Valve Thrombosis
Journal of the American College of Cardiology, 2015
Early postoperative arrhythmias after pediatric cardiac surgery
Asian cardiovascular & thoracic annals, Jan 12, 2015
This prospective study proposed to determine the incidence, risk factors, and management protocol... more This prospective study proposed to determine the incidence, risk factors, and management protocols for early postoperative arrhythmias after pediatric cardiac surgery, with focus on outcomes, using a uniform protocol, and also to see if children operated on at a later age have different issues from those operated on earlier. Of 224 consecutive pediatric patients undergoing cardiac surgery from September 2013 to July 2014, 24 were excluded because their procedures were performed without cardiopulmonary bypass. The median age was 24 months (mean 50.1 ± 62.4 months, range 0.5-216 months). Fifteen (7.5%) patients developed arrhythmia, the most common was junctional ectopic tachycardia (n = 7, 46.6%) followed by supraventricular tachycardia (n = 5, 33.3%). All junctional ectopic tachycardias occurred within 24 h of intensive care unit admission. Of the 7 patients with junctional ectopic tachycardia, 5 responded to conventional measures and 2 required amiodarone infusion. There was a sign...
Indian Journal of Thoracic and Cardiovascular Surgery, 2000
Objective. One hundred and forty seven patients with aneurysm of sinus of Valsalva (ASV) underwen... more Objective. One hundred and forty seven patients with aneurysm of sinus of Valsalva (ASV) underwent surgery between January 1977 and June 2000. The morphological features and the surgical outcome in these patients were analyzed. Patients and Methods. The age ranged from 5 to 62 years (mean 27.0_+11.5 years), and all were congenital in aetiology. The aneurysm originated from the right coronary sinus in 116 (78.9%), from the non-coronary sinus in 25 (17%) from the left coronary sinus in I (0.6%) and from more than one sinus in 5 patients. In 14 patients (9.5%) the ASV remained unruptured. It ruptured into the right ventricle in 87, into the right atrium in 40 and into the left ventricle in 3 patients. In 11 instances, the ASV dissected into the interventricular septum. A ventricular septal defect was present in 63 (43%) patients and in the majority (n=56) it was subarterial. Moderate to severe aortic regurgitation was present in 43 patients. Surgical correction was through a bicameral approach (n=111) or through the aorta (n=28) or the chamber of rupture (n=8). Results. There were 3 operative deaths and 5 late deaths over a follow up of 2 months to 23 years (mean 100.7_+64.7 months). Acturial and event free survival at 23 years were 94.0%_+3.0% and 82.0%_+6.0% respectively. Presence of moderate or severe aortic regurgitation was significantly associated with reduced event free survival. A comparison of the Indian patients with patients collected from the literature, revealed that the Indian patients represent a separate subset of patients and can be placed in middle of the spectrum between the Oriental and the Western patients. Indian patients represent a different set of patients. Adequate surgery yields gratifying early and late results.
The expanding indications for the Lecompte maneuver
World journal for pediatric & congenital heart surgery, 2014
Since the anterior translocation of the pulmonary arteries in relation to the aorta (Lecompte man... more Since the anterior translocation of the pulmonary arteries in relation to the aorta (Lecompte maneuver) was first described in 1981, its indications have continued to expand. In this review, we discuss the physiological basis and the expanding indications for this maneuver.
Cortriatriatum with classical Raghib complex: a rare anatomic association
World journal for pediatric & congenital heart surgery, 2014
Cortriatriatum with Raghib's complex is a rarely reported entity. An 18-month-old baby who pr... more Cortriatriatum with Raghib's complex is a rarely reported entity. An 18-month-old baby who presented with tachypnea and cyanosis was diagnosed to have cortriatriatum sinistrum along with a persistant left superior caval vein draining to the left atrium through an unroofed coronary sinus. The child underwent successful surgical correction with excision of the cortriatriatum and baffling of the left superior caval vein to the right atrium.
Annals of pediatric cardiology, 2014
Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a ca... more Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a cause of increased morbidity and mortality. Dexmedetomidine (DEX) is an α2 adrenoreceptor agonist, has properties of controlling tachyarrhythmia by regulating the sympatho-adrenal system. To evaluate the efficacy of DEX for control of junctional ectopic tachycardia after repair of Tetralogy of Fallot (TOF). Two hundred and twenty pediatric cardiac patients with TOFs were enrolled in a prospective randomized control study. Patients underwent correction surgery. They were divided into two groups, i.e., Group 1 (DEX) and Group 2 (control). Heart rate, rhythm, mean arterial pressure (MAP) were recorded after the anesthetic induction (T1), after termination of bypass (T2), after 04 hours (T3), and 08 hours after transferring the patient to intensive care unit (ICU; T4). Heart rate was comparable between two groups before starting the drug but statistically significant after bypass until 08 hour...
Successful management of multiple infected sub-mitral aneurysms of left ventricle
Annals of pediatric cardiology, 2014
Sub-mitral aneurysms are rarely reported clinical entity. Though a variety of etiologies are prop... more Sub-mitral aneurysms are rarely reported clinical entity. Though a variety of etiologies are proposed, congenital weakness of the mitral valve annulus is the most widely accepted one. A 17-year-old boy with sub-mitral aneurysm presented with severe mitral regurgitation, which was diagnosed by echocardiography and successfully managed surgically. The aneurysm wall was positive for Staphylococcus aureus, and patient was treated with intensive antibiotics.
JACC. Cardiovascular interventions, 2014
A 28-year-old woman with valvular and infundibular pulmonary narrowing (peak Doppler gradients of... more A 28-year-old woman with valvular and infundibular pulmonary narrowing (peak Doppler gradients of 120 mm Hg) had presented to us in the last trimester of pregnancy. She had an uneventful delivery, and subsequently, she underwent elective pulmonary valve balloon dilation (Figs. 1A and 1B). Following the valvuloplasty, the right ventricular (RV) pressures rose markedly despite adequate dilation of the pulmonary valve, and the gradients across the valve and at the infundibulum level were 30 and 100 mm Hg, respectively. She remained stable and was started on oral metoprolol (sustained release) 50 mg twice daily. Repeat echocardiogram following 6 months of therapy with metoprolol Figure 1. Angiographic Details of the Procedure (A) Right ventricular angiogram in anteroposterior view showing tight infundibular (large, open arrow) and valvular (thin arrow) pulmonary stenosis. (B) Fluoroscopic image in lateral view showing pulmonary valve balloon dilation with an appropriately-sized balloon. (C) Right coronary injection in the right anterior oblique (RAO) view showing the right coronary artery and the separate origin of the conal artery (arrow). (D) Fluoroscopic image in RAO view with injection made through an over-the-wire coronary balloon (arrow) showing selective opacification of the conal artery (Online Videos . The guidewire placed in the native right coronary artery for stability can also be seen.
Hemitruncus with ventricular septal defect in a 6-year-old child
Annals of pediatric cardiology, 2013
We report a 6-year-old girl with anomalous origin of the right pulmonary artery from the aorta as... more We report a 6-year-old girl with anomalous origin of the right pulmonary artery from the aorta associated with a large ventricular septal defect. The challenges in the assessment of operability and issues in the surgical management are discussed.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014
Tetralogy of Fallot (TOF) with hemitruncus (HT) is a rare entity. In this report, we present our ... more Tetralogy of Fallot (TOF) with hemitruncus (HT) is a rare entity. In this report, we present our experience with this condition over the last 20 years. Between January 1994 and June 2013, 11 patients with HT and TOF underwent surgery at the All India Institute of Medical Sciences, New Delhi, India. All available clinical, radiographic, echocardiographic, cardiac catheterization, operative and follow-up data were reviewed. The mean age was 73 ± 7.1 months (range 7 months to 18 years) and the mean weight was 15.7 ± 1.2 kg. The mean preoperative saturation was 79.3 ± 11.7% (range 62-92%). Six patients had anomalous left pulmonary artery (PA), whereas 5 had an anomalous right PA arising from the aorta. Surgical procedures consisted of complete intracardiac repair of TOF with direct implantation of the anomalous PA into the main PA (n = 7), intracardiac repair of TOF with an interposition saphenous vein graft between the right PA and main PA (n = 1), and reconstruction of the left PA wit...
Double aortic arch as a source of airway obstruction in a child
Annals of Cardiac Anaesthesia
Double aortic arch (DAA) is a congenital vascular anomaly. The diagnosis was difficult till the c... more Double aortic arch (DAA) is a congenital vascular anomaly. The diagnosis was difficult till the child was symptomatic, and other causes were ruled out. We present the interesting images of a child of respiratory distress because of tracheal compression from DAA.
Heart, lung & circulation, 2014
A simplified technique to fix the commissural pillar of the pulmonary valve at the time of right ... more A simplified technique to fix the commissural pillar of the pulmonary valve at the time of right ventricular outflow tract reconstruction during the arterial switch operation is presented.
Influence of crossover on mortality in a randomized study of revascularization in patients with systolic heart failure and coronary artery disease
Circulation. Heart failure, 2013
To assess the influence of therapy crossovers on treatment comparisons and mortality at 5 years i... more To assess the influence of therapy crossovers on treatment comparisons and mortality at 5 years in patients with ischemic heart disease and heart failure randomly assigned to medical therapy alone (MED) or to MED and coronary artery bypass graft (CABG) surgery in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. The influence of early crossover (within the first year after randomization) on 5-year mortality was assessed using time-dependent multivariable Cox models. CABG was performed in 65/602 patients (10.8%) assigned to MED, and 55/610 patients (9.0%) assigned to CABG received MED only. Common reasons for crossover from MED to CABG were progressive symptoms or acute decompensation. MED-assigned patients who underwent CABG had lower 5-year mortality than those who received MED only (25% vs 42%; hazard ratio, 0.50; 95% confidence interval, 0.30-0.85; P=0.008).The main reason for crossover from CABG to MED was patient/family decision. Five patients did not undergo the...
International Journal of Cardiology, 2000
BackgroundThe majority of the protocols for cardiomyocyte differentiation of MSC use 5-azacytidin... more BackgroundThe majority of the protocols for cardiomyocyte differentiation of MSC use 5-azacytidine as an inducer. As transforming growth factor β1 and 5-azacytidine share similar target signaling pathways, we examined whether transforming growth factor β1 can play a role in cardiac differentiation process in human mesenchymal stem cell of bone marrow origin.
Indian Journal of Thoracic and Cardiovascular Surgery, 2004
Background: Bentall procedure and its modification is the standard surgical management option for... more Background: Bentall procedure and its modification is the standard surgical management option for aneurysmal diseases involving ascending aorta and the aotic valve. The progressive nature of the aortic disease and the development of early and late procedure ralated complications warrant a dedicated clinical and investigative follow up.
Annals of Thoracic Surgery, 2005
SA, Robinowitz M, Mueller KH, Virmani R. Total anomalous origin of the coronary arteries from the... more SA, Robinowitz M, Mueller KH, Virmani R. Total anomalous origin of the coronary arteries from the pulmonary artery. Paediatr Cardiol 1986;7(1):11-18. 3. Bogers AJJC, Gittebberger-de Groot AC, Poelmann RE, Huysmans HA. Development of the origin of the coronary arteries, a matter of ingrowth or outgrowth? Anat Embryol 1989;180: 437-41. 4. Pinsky WW, Gillette PC, Duff DF, et al. Anomalous origin of left coronary artery from the pulmonary artery with ventricular septal defect. Circulation 1978;57(5):1026 -30. 5. Cottrill CM, Davis D, McMillen M, O'Connor WN, Noonan JA, Todd EP. Anomalous left coronary artery from the pulmonary artery: significance of associated intracardiac defects. J Am Coll Cardiol 1985;6(1):237-42. 6. Levin SE, Dansky R, Kinsley RH. Origin of left coronary artery from right pulmonary artery co-existing with coarctation of the aorta. Int J Cardiol 1990;27(1):31-6. 7. Ma JS, Choe G, Hwang TJ, Oh BS, Nam JH. Anomalous origin of the left anterior descending coronary artery from the pulmonary trunk associated with type B interrupted aortic arch. Pediatr Cardiol 1994;15(3):143-5. Five patients of right pulmonary artery-to-left atrium communication presented with special emphasis on the clinical presentation, anatomic variations, diagnostic considerations, and management options. An individualized management algorithm is recommended. (Ann Thorac Surg 2005;80:336 -8)
International Journal of Cardiology, 1999
A 2-year-old child with aortico-right ventricular tunnel is reported for its rarity. The right co... more A 2-year-old child with aortico-right ventricular tunnel is reported for its rarity. The right coronary artery originated from the distal end of the tunnel. The frequent occurrence of coronary artery origin abnormality with this anomaly is highlighted.
Seminars in Thoracic and Cardiovascular Surgery, 2017
Comparison of del Nido and St Thomas cardioplegia solutions in pediatric patients: A prospective ... more Comparison of del Nido and St Thomas cardioplegia solutions in pediatric patients: A prospective randomized clinical trial Running head: Comparison of Delnido and St Thomas cardioplegia
Interactive cardiovascular and thoracic surgery, Jan 11, 2017
The Fontan procedure [total cavopulmonary connection (TCPC)] is the final palliation for patients... more The Fontan procedure [total cavopulmonary connection (TCPC)] is the final palliation for patients with univentricular physiology. We studied differential perfusion ratio and percentage uptake of a radiotracer in different zones of each lung following TCPC. Between July 2015 and June 2017, 45 patients underwent 99mTc macroaggregated albumin lung perfusion scan at a mean follow-up period of 49.3 ± SD 26.1 days following TCPC. Differential perfusion ratio and percentage uptake of the radiotracer in the upper, middle and lower zones of each lung were calculated. Post-foot injection [inferior vena cava (IVC) injection], preferential flow to the lungs was as follows: left lung (n = 13, 30.2%), right lung (n = 13, 30.2%) and uniformly to both lungs (n= 17, 39.6%). Post-arm injection [superior vena cava (SVC) injection], preferential flow to the lungs was as follows: left lung (n = 13, 30.2%), right lung (n = 22, 51.2%) and uniformly to both lungs (n= 8, 18.6%). The middle zone was perfused...
Percutaneous transvenous mitral commissurotomy using Inoue balloon in children less than 12 years
Catheterization and Cardiovascular Diagnosis, 1998
Spontaneous Normalization of Valve Function After Failed Fibrinolytic Therapy for Left-Sided Prosthetic Valve Thrombosis
Journal of the American College of Cardiology, 2015
Early postoperative arrhythmias after pediatric cardiac surgery
Asian cardiovascular & thoracic annals, Jan 12, 2015
This prospective study proposed to determine the incidence, risk factors, and management protocol... more This prospective study proposed to determine the incidence, risk factors, and management protocols for early postoperative arrhythmias after pediatric cardiac surgery, with focus on outcomes, using a uniform protocol, and also to see if children operated on at a later age have different issues from those operated on earlier. Of 224 consecutive pediatric patients undergoing cardiac surgery from September 2013 to July 2014, 24 were excluded because their procedures were performed without cardiopulmonary bypass. The median age was 24 months (mean 50.1 ± 62.4 months, range 0.5-216 months). Fifteen (7.5%) patients developed arrhythmia, the most common was junctional ectopic tachycardia (n = 7, 46.6%) followed by supraventricular tachycardia (n = 5, 33.3%). All junctional ectopic tachycardias occurred within 24 h of intensive care unit admission. Of the 7 patients with junctional ectopic tachycardia, 5 responded to conventional measures and 2 required amiodarone infusion. There was a sign...
Indian Journal of Thoracic and Cardiovascular Surgery, 2000
Objective. One hundred and forty seven patients with aneurysm of sinus of Valsalva (ASV) underwen... more Objective. One hundred and forty seven patients with aneurysm of sinus of Valsalva (ASV) underwent surgery between January 1977 and June 2000. The morphological features and the surgical outcome in these patients were analyzed. Patients and Methods. The age ranged from 5 to 62 years (mean 27.0_+11.5 years), and all were congenital in aetiology. The aneurysm originated from the right coronary sinus in 116 (78.9%), from the non-coronary sinus in 25 (17%) from the left coronary sinus in I (0.6%) and from more than one sinus in 5 patients. In 14 patients (9.5%) the ASV remained unruptured. It ruptured into the right ventricle in 87, into the right atrium in 40 and into the left ventricle in 3 patients. In 11 instances, the ASV dissected into the interventricular septum. A ventricular septal defect was present in 63 (43%) patients and in the majority (n=56) it was subarterial. Moderate to severe aortic regurgitation was present in 43 patients. Surgical correction was through a bicameral approach (n=111) or through the aorta (n=28) or the chamber of rupture (n=8). Results. There were 3 operative deaths and 5 late deaths over a follow up of 2 months to 23 years (mean 100.7_+64.7 months). Acturial and event free survival at 23 years were 94.0%_+3.0% and 82.0%_+6.0% respectively. Presence of moderate or severe aortic regurgitation was significantly associated with reduced event free survival. A comparison of the Indian patients with patients collected from the literature, revealed that the Indian patients represent a separate subset of patients and can be placed in middle of the spectrum between the Oriental and the Western patients. Indian patients represent a different set of patients. Adequate surgery yields gratifying early and late results.
The expanding indications for the Lecompte maneuver
World journal for pediatric & congenital heart surgery, 2014
Since the anterior translocation of the pulmonary arteries in relation to the aorta (Lecompte man... more Since the anterior translocation of the pulmonary arteries in relation to the aorta (Lecompte maneuver) was first described in 1981, its indications have continued to expand. In this review, we discuss the physiological basis and the expanding indications for this maneuver.
Cortriatriatum with classical Raghib complex: a rare anatomic association
World journal for pediatric & congenital heart surgery, 2014
Cortriatriatum with Raghib's complex is a rarely reported entity. An 18-month-old baby who pr... more Cortriatriatum with Raghib's complex is a rarely reported entity. An 18-month-old baby who presented with tachypnea and cyanosis was diagnosed to have cortriatriatum sinistrum along with a persistant left superior caval vein draining to the left atrium through an unroofed coronary sinus. The child underwent successful surgical correction with excision of the cortriatriatum and baffling of the left superior caval vein to the right atrium.
Annals of pediatric cardiology, 2014
Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a ca... more Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a cause of increased morbidity and mortality. Dexmedetomidine (DEX) is an α2 adrenoreceptor agonist, has properties of controlling tachyarrhythmia by regulating the sympatho-adrenal system. To evaluate the efficacy of DEX for control of junctional ectopic tachycardia after repair of Tetralogy of Fallot (TOF). Two hundred and twenty pediatric cardiac patients with TOFs were enrolled in a prospective randomized control study. Patients underwent correction surgery. They were divided into two groups, i.e., Group 1 (DEX) and Group 2 (control). Heart rate, rhythm, mean arterial pressure (MAP) were recorded after the anesthetic induction (T1), after termination of bypass (T2), after 04 hours (T3), and 08 hours after transferring the patient to intensive care unit (ICU; T4). Heart rate was comparable between two groups before starting the drug but statistically significant after bypass until 08 hour...
Successful management of multiple infected sub-mitral aneurysms of left ventricle
Annals of pediatric cardiology, 2014
Sub-mitral aneurysms are rarely reported clinical entity. Though a variety of etiologies are prop... more Sub-mitral aneurysms are rarely reported clinical entity. Though a variety of etiologies are proposed, congenital weakness of the mitral valve annulus is the most widely accepted one. A 17-year-old boy with sub-mitral aneurysm presented with severe mitral regurgitation, which was diagnosed by echocardiography and successfully managed surgically. The aneurysm wall was positive for Staphylococcus aureus, and patient was treated with intensive antibiotics.
JACC. Cardiovascular interventions, 2014
A 28-year-old woman with valvular and infundibular pulmonary narrowing (peak Doppler gradients of... more A 28-year-old woman with valvular and infundibular pulmonary narrowing (peak Doppler gradients of 120 mm Hg) had presented to us in the last trimester of pregnancy. She had an uneventful delivery, and subsequently, she underwent elective pulmonary valve balloon dilation (Figs. 1A and 1B). Following the valvuloplasty, the right ventricular (RV) pressures rose markedly despite adequate dilation of the pulmonary valve, and the gradients across the valve and at the infundibulum level were 30 and 100 mm Hg, respectively. She remained stable and was started on oral metoprolol (sustained release) 50 mg twice daily. Repeat echocardiogram following 6 months of therapy with metoprolol Figure 1. Angiographic Details of the Procedure (A) Right ventricular angiogram in anteroposterior view showing tight infundibular (large, open arrow) and valvular (thin arrow) pulmonary stenosis. (B) Fluoroscopic image in lateral view showing pulmonary valve balloon dilation with an appropriately-sized balloon. (C) Right coronary injection in the right anterior oblique (RAO) view showing the right coronary artery and the separate origin of the conal artery (arrow). (D) Fluoroscopic image in RAO view with injection made through an over-the-wire coronary balloon (arrow) showing selective opacification of the conal artery (Online Videos . The guidewire placed in the native right coronary artery for stability can also be seen.
Hemitruncus with ventricular septal defect in a 6-year-old child
Annals of pediatric cardiology, 2013
We report a 6-year-old girl with anomalous origin of the right pulmonary artery from the aorta as... more We report a 6-year-old girl with anomalous origin of the right pulmonary artery from the aorta associated with a large ventricular septal defect. The challenges in the assessment of operability and issues in the surgical management are discussed.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014
Tetralogy of Fallot (TOF) with hemitruncus (HT) is a rare entity. In this report, we present our ... more Tetralogy of Fallot (TOF) with hemitruncus (HT) is a rare entity. In this report, we present our experience with this condition over the last 20 years. Between January 1994 and June 2013, 11 patients with HT and TOF underwent surgery at the All India Institute of Medical Sciences, New Delhi, India. All available clinical, radiographic, echocardiographic, cardiac catheterization, operative and follow-up data were reviewed. The mean age was 73 ± 7.1 months (range 7 months to 18 years) and the mean weight was 15.7 ± 1.2 kg. The mean preoperative saturation was 79.3 ± 11.7% (range 62-92%). Six patients had anomalous left pulmonary artery (PA), whereas 5 had an anomalous right PA arising from the aorta. Surgical procedures consisted of complete intracardiac repair of TOF with direct implantation of the anomalous PA into the main PA (n = 7), intracardiac repair of TOF with an interposition saphenous vein graft between the right PA and main PA (n = 1), and reconstruction of the left PA wit...
Double aortic arch as a source of airway obstruction in a child
Annals of Cardiac Anaesthesia
Double aortic arch (DAA) is a congenital vascular anomaly. The diagnosis was difficult till the c... more Double aortic arch (DAA) is a congenital vascular anomaly. The diagnosis was difficult till the child was symptomatic, and other causes were ruled out. We present the interesting images of a child of respiratory distress because of tracheal compression from DAA.
Heart, lung & circulation, 2014
A simplified technique to fix the commissural pillar of the pulmonary valve at the time of right ... more A simplified technique to fix the commissural pillar of the pulmonary valve at the time of right ventricular outflow tract reconstruction during the arterial switch operation is presented.
Influence of crossover on mortality in a randomized study of revascularization in patients with systolic heart failure and coronary artery disease
Circulation. Heart failure, 2013
To assess the influence of therapy crossovers on treatment comparisons and mortality at 5 years i... more To assess the influence of therapy crossovers on treatment comparisons and mortality at 5 years in patients with ischemic heart disease and heart failure randomly assigned to medical therapy alone (MED) or to MED and coronary artery bypass graft (CABG) surgery in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. The influence of early crossover (within the first year after randomization) on 5-year mortality was assessed using time-dependent multivariable Cox models. CABG was performed in 65/602 patients (10.8%) assigned to MED, and 55/610 patients (9.0%) assigned to CABG received MED only. Common reasons for crossover from MED to CABG were progressive symptoms or acute decompensation. MED-assigned patients who underwent CABG had lower 5-year mortality than those who received MED only (25% vs 42%; hazard ratio, 0.50; 95% confidence interval, 0.30-0.85; P=0.008).The main reason for crossover from CABG to MED was patient/family decision. Five patients did not undergo the...
International Journal of Cardiology, 2000
BackgroundThe majority of the protocols for cardiomyocyte differentiation of MSC use 5-azacytidin... more BackgroundThe majority of the protocols for cardiomyocyte differentiation of MSC use 5-azacytidine as an inducer. As transforming growth factor β1 and 5-azacytidine share similar target signaling pathways, we examined whether transforming growth factor β1 can play a role in cardiac differentiation process in human mesenchymal stem cell of bone marrow origin.
Indian Journal of Thoracic and Cardiovascular Surgery, 2004
Background: Bentall procedure and its modification is the standard surgical management option for... more Background: Bentall procedure and its modification is the standard surgical management option for aneurysmal diseases involving ascending aorta and the aotic valve. The progressive nature of the aortic disease and the development of early and late procedure ralated complications warrant a dedicated clinical and investigative follow up.
Annals of Thoracic Surgery, 2005
SA, Robinowitz M, Mueller KH, Virmani R. Total anomalous origin of the coronary arteries from the... more SA, Robinowitz M, Mueller KH, Virmani R. Total anomalous origin of the coronary arteries from the pulmonary artery. Paediatr Cardiol 1986;7(1):11-18. 3. Bogers AJJC, Gittebberger-de Groot AC, Poelmann RE, Huysmans HA. Development of the origin of the coronary arteries, a matter of ingrowth or outgrowth? Anat Embryol 1989;180: 437-41. 4. Pinsky WW, Gillette PC, Duff DF, et al. Anomalous origin of left coronary artery from the pulmonary artery with ventricular septal defect. Circulation 1978;57(5):1026 -30. 5. Cottrill CM, Davis D, McMillen M, O'Connor WN, Noonan JA, Todd EP. Anomalous left coronary artery from the pulmonary artery: significance of associated intracardiac defects. J Am Coll Cardiol 1985;6(1):237-42. 6. Levin SE, Dansky R, Kinsley RH. Origin of left coronary artery from right pulmonary artery co-existing with coarctation of the aorta. Int J Cardiol 1990;27(1):31-6. 7. Ma JS, Choe G, Hwang TJ, Oh BS, Nam JH. Anomalous origin of the left anterior descending coronary artery from the pulmonary trunk associated with type B interrupted aortic arch. Pediatr Cardiol 1994;15(3):143-5. Five patients of right pulmonary artery-to-left atrium communication presented with special emphasis on the clinical presentation, anatomic variations, diagnostic considerations, and management options. An individualized management algorithm is recommended. (Ann Thorac Surg 2005;80:336 -8)
International Journal of Cardiology, 1999
A 2-year-old child with aortico-right ventricular tunnel is reported for its rarity. The right co... more A 2-year-old child with aortico-right ventricular tunnel is reported for its rarity. The right coronary artery originated from the distal end of the tunnel. The frequent occurrence of coronary artery origin abnormality with this anomaly is highlighted.