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Papers by Madhusudan Ganigara

IJC Heart & Vessels, 2014

The time course of progressive dilatation of the right ventricle (RV) in adults with pulmonary re... more The time course of progressive dilatation of the right ventricle (RV) in adults with pulmonary regurgitation (PR) late after repair of tetralogy of Fallot (TOF) is poorly characterized.

Annals of pediatric cardiology, 2014

Sinus venosus atrial septal defects (SV-ASDs) are inter-atrial communications caused by a deficie... more Sinus venosus atrial septal defects (SV-ASDs) are inter-atrial communications caused by a deficiency of the common wall between the superior or inferior vena cava and the right-sided pulmonary veins. The diagnosis can be challenging, especially in adults with delayed presentation. We present images that illustrate an example of the role of cardiac magnetic resonance imaging (CMRI) in the diagnosis and follow-up of a patient with SV-ASD.

Heart, Lung and Circulation, 2013

Methods: Eighteen adult patients with repaired TOF and severe pulmonary regurgitation (PR) with r... more Methods: Eighteen adult patients with repaired TOF and severe pulmonary regurgitation (PR) with right ventricular (RV) dilatation requiring PVR for clinical reasons (age; 25 ± 8 years) were recruited to undergo cardiac MRI (1.5 T) and cardiopulmonary exercise testing before and 14 ± 3 months after PVR.

Congenital Heart Disease, 2011

There is scanty information on the outcome of adult congenital heart disease surgery from the dev... more There is scanty information on the outcome of adult congenital heart disease surgery from the developing world. This was a retrospective chart review of the surgical outcome of 153 adults with congenital heart disease over a 5-year period. Surgical atrial septal defect closure was considered "simple" while all other surgeries were considered "complex." There were 102 patients in the "simple" group and 51 in the "complex" group. Only three (2%) patients had prior operations. The "complex" group had longer bypass time and cross clamp time. Intensive care unit stay, ventilation time, and inotrope administration were longer. Major complications were more common and there were two deaths in the "complex" group. Age more than 30 years, cyanosis, and New York Heart Association class more than II were predictors of longer stay in the intensive care unit. Surgical repair of Tetralogy of Fallot in adults tended to have a longer ventilation time and intensive care unit stay with a mortality of 4%. At follow up, all patients were in New York Heart Association class I or II. Improvement of the functional class with negligible adverse events was noted in both groups. A retrospective evaluation of 153 adults with congenital heart disease who underwent open heart surgery at a single center in India showed strikingly fewer reoperations compared with large European studies. There was a similar prevalence of complex lesions. Surgical mortality was low, and long-term functional outcome was gratifying.

Asian Cardiovascular and Thoracic Annals, 2010

The outcomes of 33 consecutive extracardiac Fontan operations performed between 1999 and 2008 in ... more The outcomes of 33 consecutive extracardiac Fontan operations performed between 1999 and 2008 in patients who mostly had initial Glenn shunts beyond infancy were reviewed. Preoperatively, the median oxygen saturation was 76.2% and mean pulmonary artery pressure was 10.5 mm Hg. The median age was 4.1 years at Glenn shunt procedure and 10 years at Fontan operation. The duration of chest tube drainage was longer in these patients than in series where Glenn shunts were created at a younger age. All patients received warfarin for 1 year, then warfarin and/or aspirin. At follow-up (median, 14 months), there was no significant ventricular dysfunction. Median oxygen saturation at the last follow-up was 92%. All patients in sinus rhythm preoperatively continued in this status. There was no Fontan failure or mortality. All patients were in New York Heart Association class I or II, although objective cardiopulmonary exercise evaluation in 8 patients showed impaired exercise tolerance. Despite a trend towards prolonged pleural effusion, there was no adverse outcome in the short or intermediate term. Long-term follow-up is required to see whether delayed creation of a Glenn shunt is associated with late disadvantages.

Annals of Pediatric Cardiology, 2011

In LEOPARD syndrome, mutations affecting exon 13 of the PTPN11 gene have been correlated with a r... more In LEOPARD syndrome, mutations affecting exon 13 of the PTPN11 gene have been correlated with a rapidly progressive severe biventricular obstructive hypertrophic cardiomyopathy (HCM). This is a report of early onset severe HCM in an infant with LEOPARD syndrome and an unusual mutation in exon 13, showing genotype-phenotype correlation.

International Journal of Cardiology, 2014

IJC Heart & Vessels, 2014

The time course of progressive dilatation of the right ventricle (RV) in adults with pulmonary re... more The time course of progressive dilatation of the right ventricle (RV) in adults with pulmonary regurgitation (PR) late after repair of tetralogy of Fallot (TOF) is poorly characterized.

Annals of pediatric cardiology, 2014

Sinus venosus atrial septal defects (SV-ASDs) are inter-atrial communications caused by a deficie... more Sinus venosus atrial septal defects (SV-ASDs) are inter-atrial communications caused by a deficiency of the common wall between the superior or inferior vena cava and the right-sided pulmonary veins. The diagnosis can be challenging, especially in adults with delayed presentation. We present images that illustrate an example of the role of cardiac magnetic resonance imaging (CMRI) in the diagnosis and follow-up of a patient with SV-ASD.

Heart, Lung and Circulation, 2013

Methods: Eighteen adult patients with repaired TOF and severe pulmonary regurgitation (PR) with r... more Methods: Eighteen adult patients with repaired TOF and severe pulmonary regurgitation (PR) with right ventricular (RV) dilatation requiring PVR for clinical reasons (age; 25 ± 8 years) were recruited to undergo cardiac MRI (1.5 T) and cardiopulmonary exercise testing before and 14 ± 3 months after PVR.

Congenital Heart Disease, 2011

There is scanty information on the outcome of adult congenital heart disease surgery from the dev... more There is scanty information on the outcome of adult congenital heart disease surgery from the developing world. This was a retrospective chart review of the surgical outcome of 153 adults with congenital heart disease over a 5-year period. Surgical atrial septal defect closure was considered "simple" while all other surgeries were considered "complex." There were 102 patients in the "simple" group and 51 in the "complex" group. Only three (2%) patients had prior operations. The "complex" group had longer bypass time and cross clamp time. Intensive care unit stay, ventilation time, and inotrope administration were longer. Major complications were more common and there were two deaths in the "complex" group. Age more than 30 years, cyanosis, and New York Heart Association class more than II were predictors of longer stay in the intensive care unit. Surgical repair of Tetralogy of Fallot in adults tended to have a longer ventilation time and intensive care unit stay with a mortality of 4%. At follow up, all patients were in New York Heart Association class I or II. Improvement of the functional class with negligible adverse events was noted in both groups. A retrospective evaluation of 153 adults with congenital heart disease who underwent open heart surgery at a single center in India showed strikingly fewer reoperations compared with large European studies. There was a similar prevalence of complex lesions. Surgical mortality was low, and long-term functional outcome was gratifying.

Asian Cardiovascular and Thoracic Annals, 2010

The outcomes of 33 consecutive extracardiac Fontan operations performed between 1999 and 2008 in ... more The outcomes of 33 consecutive extracardiac Fontan operations performed between 1999 and 2008 in patients who mostly had initial Glenn shunts beyond infancy were reviewed. Preoperatively, the median oxygen saturation was 76.2% and mean pulmonary artery pressure was 10.5 mm Hg. The median age was 4.1 years at Glenn shunt procedure and 10 years at Fontan operation. The duration of chest tube drainage was longer in these patients than in series where Glenn shunts were created at a younger age. All patients received warfarin for 1 year, then warfarin and/or aspirin. At follow-up (median, 14 months), there was no significant ventricular dysfunction. Median oxygen saturation at the last follow-up was 92%. All patients in sinus rhythm preoperatively continued in this status. There was no Fontan failure or mortality. All patients were in New York Heart Association class I or II, although objective cardiopulmonary exercise evaluation in 8 patients showed impaired exercise tolerance. Despite a trend towards prolonged pleural effusion, there was no adverse outcome in the short or intermediate term. Long-term follow-up is required to see whether delayed creation of a Glenn shunt is associated with late disadvantages.

Annals of Pediatric Cardiology, 2011

In LEOPARD syndrome, mutations affecting exon 13 of the PTPN11 gene have been correlated with a r... more In LEOPARD syndrome, mutations affecting exon 13 of the PTPN11 gene have been correlated with a rapidly progressive severe biventricular obstructive hypertrophic cardiomyopathy (HCM). This is a report of early onset severe HCM in an infant with LEOPARD syndrome and an unusual mutation in exon 13, showing genotype-phenotype correlation.

International Journal of Cardiology, 2014