Palleti Rajashekar - Academia.edu (original) (raw)

Papers by Palleti Rajashekar

Indian heart journal/Indian Heart Journal, Jun 1, 2024

PubMed, Jan 18, 2018

Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other ano... more Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other anomalies particularly coronary anomalies. It may be detected on transthoracic or transesophageal echocardiography. We present here a case report of a 27-year-old male patient with a QAV, the valve being regurgitant and requiring aortic valve replacement. It has been reported as isolated case reports in the literature and various theories exist to the development of QAV. The diagnosis requires a high degree of suspicion and a detailed assessment, and if asymptomatic, then patients need to be carefully followed up for the development of aortic regurgitation.

Saudi Journal of Anaesthesia, 2016

Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery ... more Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.

Journal of Cardiac Surgery, Mar 2, 2022

We report a case of a 29-year-old man with constrictive pericarditis where CT angiography inciden... more We report a case of a 29-year-old man with constrictive pericarditis where CT angiography incidentally demonstrated a dual right coronary artery (RCA). The present case highlights the diagnostic criterion for dual RCA as well as the potential clinical implications of the anomaly.

Journal of the Practice of Cardiovascular Sciences

Background: A series of lectures and workshop on lung and heart–lung transplantation were organiz... more Background: A series of lectures and workshop on lung and heart–lung transplantation were organized by the Departments of Cardiology and Cardiothoracic Surgery at All India Institute of Medical Sciences, New Delhi, and the Department of Heart and Lung Transplantation at Apollo Hospitals, Chennai. The 1st day workshop on preoperative workup part was published as Part-I in this journal in August 2018. The hands-on cadaveric workshop conducted on May 20, 2018, forms the basis of the first section of the second part (Part II a) which deals with the technique of lung transplantation. The techniques of lung transplantation and Indian scenario are also reviewed. Methodology: The technique practiced by the transplant team at Apollo Hospitals, Chennai, was used for the demonstration of donor lung, heart–lung block harvest and implanting lungs, heart–lung block, while also discussing other possible techniques. Human cadavers were used, and live high-definition audio–video transmission to the lecture hall was made. Results: Accurate figures regarding lung transplantation in India are still not available. However, as per the Indian Society for Heart and Lung Transplantation, current data suggest that overall, about 1050 heart transplants and 310 lung transplants have been done in India. Of these, it is anticipated that national data regarding number of single-lung transplants, double-lung transplants, and heart–lung transplants will be available soon. The Department of Heart and Lung Transplantation at Apollo Hospitals, Chennai, has performed a total of 69 hearts and 149 lungs in 119 patients in various combinations: isolated heart transplants (40 patients), double-lung transplantation (DLT) (43 patients), single-lung transplantation (7 patients), heart and DLT (27 patients), en bloc heart and liver transplantation (1 patient), and combined heart–lung and kidney transplantation (1 patient). While the survival data for India are not currently available, our 3-year survival for DLT is 76.2%. Conclusions: While the surgical technique demonstrated is used in most of our cases, at times, different techniques have had to be adopted based on challenges confronted on the operating table. However, we have found that developing surgical protocols and maintaining consistency in the operative techniques translates into good surgical outcomes.

Annals of Pediatric Cardiology, 2022

Journal of the Practice of Cardiovascular Sciences, Sep 1, 2020

A teenager presented with congestive heart failure due to severe aortic stenosis. She had also de... more A teenager presented with congestive heart failure due to severe aortic stenosis. She had also developed ventricular clots due to ventricular dysfunction, therefore, was taken up for emergency aortic valve replacement. To our surprise, she had bilateral superior vena cava, which has not been reported with unicuspid aortic valve and ventricular clots, to the best of our knowledge. She also had an abnormal location of coronary ostia making them susceptible to injury during routine aortotomy, but it was picked up during transesophageal echocardiography and a careful aortic incision was planned. This report emphasizes the importance of careful aortotomy in congenital aortic pathologies, where coronary ostia may be located in abnormal positions. The role of transesophageal echocardiography is paramount in this situation to find the location of coronary ostia before incising the aorta.

Heart Lung and Circulation, Apr 1, 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.

World Journal for Pediatric and Congenital Heart Surgery, Oct 1, 2012

We report a two-year-old patient with isomerism of the right atrial appendages, a functionally un... more We report a two-year-old patient with isomerism of the right atrial appendages, a functionally univentricular heart, and associated totally anomalous pulmonary venous connection. The unusual finding was an intrapulmonary course of the vertical vein. We discuss the anatomical findings, management, and outcome.

World Journal for Pediatric and Congenital Heart Surgery, Mar 25, 2014

Cortriatriatum with Raghib&am... 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.

World Journal for Pediatric and Congenital Heart Surgery, Mar 1, 2022

Background: In this prospective randomized controlled trial, we compared the standard del Nido ca... more Background: In this prospective randomized controlled trial, we compared the standard del Nido cardioplegia solution (SDN) with the modified del Nido cardioplegia solution (MDN) in which the base solution was the plain Ringer solution. Methods: A total of 80 patients aged < 12 years undergoing intracardiac repair of Tetralogy of Fallot were randomized into SDN (n = 39) or MDN (n = 41) groups. The primary outcome was a change in cardiac index (CI). Secondary outcomes were ventricular arrhythmias after the release of aortic-cross clamp, postoperative inotropic score (IS), time to peripheral rewarming, duration of mechanical ventilation, intensive care unit (ICU) length of stay, and hospital length of stay, and electron microscopic differences between the 2 groups. Cardiac Troponin-I, inflammatory markers tumor necrosis factor-α (TNF-α), and interleukin-L (IL-6) were measured. Results: Applying the noninferiority confidence interval approach, the difference between the changes in CI between the 2 groups was −0.093 L/min/m2 (95% CI: −0.46-0.27 L/min/m2) which was within the noninferiority threshold of −0.5 indicating that CI was similar in both SDN and MDN. Ventricular arrhythmias postclamp release ( P = .91), IS ( P = .09), duration of mechanical ventilation ( P = .27), ICU length of stay ( P = .50), hospital length of stay ( P = .57), IL-6 ( P = .19), TNF-α ( P = .17), Troponin-I ( P = .15), electron microscopy changes ( P > .05) were not different between groups. Conclusion: MDN was shown to be noninferior to the SDN cardioplegia in terms of preservation of cardiac index. In addition, other metrics indicative of myocardial protection were similar between groups. In developing nations where SDN is not available or is expensive, MDN cardioplegia is an acceptable alternative.

Annals of Pediatric Cardiology, 2023

Journal of Cardiac Surgery, Sep 19, 2019

The commonly used technique to facilitate intracardiac exposure during transatrial repair of tetr... more The commonly used technique to facilitate intracardiac exposure during transatrial repair of tetralogy of fallot involves considerable retraction of the tricuspid valve using retractors. We describe an alternative surgical technique in which it is possible to dispense away with the retractors. The advantages of such a technique are discussed.

Journal of Cardiac Surgery, Jun 30, 2013

We report a 3-year-old patient with tetralogy of Fallot (TOF), dextrocardia, situs inversus (SI),... more We report a 3-year-old patient with tetralogy of Fallot (TOF), dextrocardia, situs inversus (SI), and total anomalous pulmonary venous return. This combination of anomalies is extremely unusual. The management is discussed and the literature is reviewed.

Journal of Cardiac Surgery, Jul 28, 2013

Superior cavopulmonary anastomosis and total cavopulmonary anastomosis are the procedures of choi... more Superior cavopulmonary anastomosis and total cavopulmonary anastomosis are the procedures of choice for the management of patients with a functionally univentricular heart. We review the various indications, sites, advantages, and complications of a systemic to pulmonary artery shunt after the creation of superior cavopulmonary anastomosis. Systemic pulmonary artery shunt may be useful as a palliative strategy in patients who have hypoxemia and completion of total cavopulmonary anastomosis is not feasible.

Indian Journal of Thoracic and Cardiovascular Surgery, Dec 1, 2012

ABSTRACT Introduction Advances in technology have spurred innovations in most surgical discipline... more ABSTRACT Introduction Advances in technology have spurred innovations in most surgical disciplines- including cardiac surgery - directed towards minimizing invasiveness without compromising outcomes. We present our initial experience and learning curve difficulties in performing robotically assisted atrial septal defect closure in an adult population. Patients and methods Over a 4 year period between February 2008 to January 2012, we operated upon 52 patients with secundum type of Atrial Septal Defect (ASD), using the daVinci robotic system. All operations were done with peripheral cardiopulmonary bypass and direct transthoracic access to aorta for cardioplegia and aortic cross clamping. Mean age of patients was 26.8 years, mean cross-clamp, cardiopulmonary bypass and operating times were 68.4, 121.6 and 178.44 min respectively. In 4 patients, there was conversion – to sternotomy in three and to thoracotomy in one. In all patients, successful closure was confirmed by Trans Esophageal Echocardiography (TEE). Mean Intensive Care Unit (ICU) stay duration was 22.1 h and hospital stay 3.6 days. There was no mortality. In one patient, there was lung parenchymal bleeding necessitating reexploration followed by persistent air leak for 48 h. Conclusions Robotic telemanipulation enables application of endoscopic technology to performing complex intrathoracic operations safely. Patients with simple lesions like ASD who are not candidates for device closure may be offered this surgeon-friendly technology to avoid possible complications of sternotomy and enable faster recovery. Factors like - adapting to telemanipulation, setting up peripheral cardiopulmonary bypass and restricted visibility prolongs both operating times and surgeons’ learning curve but greatly minimises patient morbidity.

World Journal of Cardiovascular Surgery, 2017

Objective: For patients of TOF with pulmonary annular hypoplasia, reconstruction of right ventric... more Objective: For patients of TOF with pulmonary annular hypoplasia, reconstruction of right ventricular outflow tract (RVOT) often requires a trans annular patch (TAP). The present study aims to compare the outcomes of TOF repair using Polytetrafluoroethylene (PTFE) patch versus autologous glutaraldehyde fixed pericardial patch for RVOT reconstruction. Materials and methods: 103 consecutive patients undergoing TOF repair in whom TAP was required were randomized into two groups: Group I (pericardial patch), Group II (PTFE patch). Postoperative outcomes in terms of postoperative heart rhythm, duration of mechanical ventilation, mediastinal and pleural drainage, length of stay in intensive care unit (ICU) and hospital mortality were assessed. A separate team of cardiologists independently evaluated pre-and post-operative gradients across the RVOT, degree of pulmonary insufficiency, right ventricular systolic function. Results: There were no significant differences between the two groups in terms of the incidence of postoperative arrhythmias, duration of mechanical ventilation, length of intensive care unit or hospital stay. The requirement of inotropes was no different in the PTFE patch group as compared with the pericardial patch group (16.84 ± 7.04 vs. 17.90 ± 6.71, median 19 vs. 20, p = 0.825). The re-exploration rate was higher in the PTFE group as compared with the pericardial patch group (6 vs. 1). Postoperative Echocar-diography revealed no differences in the RV systolic function between the two groups before discharge. Conclusion: In patients undergoing TOF repair, using a PTFE patch yields comparable results. However, the efficacy of PTFE will only be established once; mid-term and long-term results How to cite this paper:

Journal of Cardiac Surgery, Dec 17, 2013

Total anomalous pulmonary venous connection can be encountered in patients with a univentricular ... more Total anomalous pulmonary venous connection can be encountered in patients with a univentricular heart and must be addressed to at the time of univentricular palliation. We present an alternative technique of re-channeling of the pulmonary venous return toward the left heart in these patients.

Asian Cardiovascular and Thoracic Annals, Apr 1, 2012

An alternative technique for channeling the pulmonary venous return towards the left atrium in pa... more An alternative technique for channeling the pulmonary venous return towards the left atrium in patients with total anomalous pulmonary venous return to the coronary sinus is described. The advantages of this technique, which avoids the use of patch material and prevents arrhythmias, are discussed.

Journal of Pediatric Hematology Oncology, Sep 9, 2020

Primary intracardiac teratoma is a rare cardiac tumor with few cases reports in neonates and chil... more Primary intracardiac teratoma is a rare cardiac tumor with few cases reports in neonates and children. The authors present a case of an 8-year-old boy diagnosed with a cystic mass within the heart. The mass lesion was originating from the interventricular septum and was obliterating the ventricular chambers. Clinically, the mass was suspected to be a hydatid cyst. Surgical excision of the cyst was done that was confirmed histopathologically as mature teratoma. Although rare, it should be considered in the differential diagnosis of cystic lesions of heart when evaluating mass lesions in the pediatric age group.

Indian heart journal/Indian Heart Journal, Jun 1, 2024

PubMed, Jan 18, 2018

Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other ano... more Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other anomalies particularly coronary anomalies. It may be detected on transthoracic or transesophageal echocardiography. We present here a case report of a 27-year-old male patient with a QAV, the valve being regurgitant and requiring aortic valve replacement. It has been reported as isolated case reports in the literature and various theories exist to the development of QAV. The diagnosis requires a high degree of suspicion and a detailed assessment, and if asymptomatic, then patients need to be carefully followed up for the development of aortic regurgitation.

Saudi Journal of Anaesthesia, 2016

Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery ... more Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.

Journal of Cardiac Surgery, Mar 2, 2022

We report a case of a 29-year-old man with constrictive pericarditis where CT angiography inciden... more We report a case of a 29-year-old man with constrictive pericarditis where CT angiography incidentally demonstrated a dual right coronary artery (RCA). The present case highlights the diagnostic criterion for dual RCA as well as the potential clinical implications of the anomaly.

Journal of the Practice of Cardiovascular Sciences

Background: A series of lectures and workshop on lung and heart–lung transplantation were organiz... more Background: A series of lectures and workshop on lung and heart–lung transplantation were organized by the Departments of Cardiology and Cardiothoracic Surgery at All India Institute of Medical Sciences, New Delhi, and the Department of Heart and Lung Transplantation at Apollo Hospitals, Chennai. The 1st day workshop on preoperative workup part was published as Part-I in this journal in August 2018. The hands-on cadaveric workshop conducted on May 20, 2018, forms the basis of the first section of the second part (Part II a) which deals with the technique of lung transplantation. The techniques of lung transplantation and Indian scenario are also reviewed. Methodology: The technique practiced by the transplant team at Apollo Hospitals, Chennai, was used for the demonstration of donor lung, heart–lung block harvest and implanting lungs, heart–lung block, while also discussing other possible techniques. Human cadavers were used, and live high-definition audio–video transmission to the lecture hall was made. Results: Accurate figures regarding lung transplantation in India are still not available. However, as per the Indian Society for Heart and Lung Transplantation, current data suggest that overall, about 1050 heart transplants and 310 lung transplants have been done in India. Of these, it is anticipated that national data regarding number of single-lung transplants, double-lung transplants, and heart–lung transplants will be available soon. The Department of Heart and Lung Transplantation at Apollo Hospitals, Chennai, has performed a total of 69 hearts and 149 lungs in 119 patients in various combinations: isolated heart transplants (40 patients), double-lung transplantation (DLT) (43 patients), single-lung transplantation (7 patients), heart and DLT (27 patients), en bloc heart and liver transplantation (1 patient), and combined heart–lung and kidney transplantation (1 patient). While the survival data for India are not currently available, our 3-year survival for DLT is 76.2%. Conclusions: While the surgical technique demonstrated is used in most of our cases, at times, different techniques have had to be adopted based on challenges confronted on the operating table. However, we have found that developing surgical protocols and maintaining consistency in the operative techniques translates into good surgical outcomes.

Annals of Pediatric Cardiology, 2022

Journal of the Practice of Cardiovascular Sciences, Sep 1, 2020

A teenager presented with congestive heart failure due to severe aortic stenosis. She had also de... more A teenager presented with congestive heart failure due to severe aortic stenosis. She had also developed ventricular clots due to ventricular dysfunction, therefore, was taken up for emergency aortic valve replacement. To our surprise, she had bilateral superior vena cava, which has not been reported with unicuspid aortic valve and ventricular clots, to the best of our knowledge. She also had an abnormal location of coronary ostia making them susceptible to injury during routine aortotomy, but it was picked up during transesophageal echocardiography and a careful aortic incision was planned. This report emphasizes the importance of careful aortotomy in congenital aortic pathologies, where coronary ostia may be located in abnormal positions. The role of transesophageal echocardiography is paramount in this situation to find the location of coronary ostia before incising the aorta.

Heart Lung and Circulation, Apr 1, 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.

World Journal for Pediatric and Congenital Heart Surgery, Oct 1, 2012

We report a two-year-old patient with isomerism of the right atrial appendages, a functionally un... more We report a two-year-old patient with isomerism of the right atrial appendages, a functionally univentricular heart, and associated totally anomalous pulmonary venous connection. The unusual finding was an intrapulmonary course of the vertical vein. We discuss the anatomical findings, management, and outcome.

World Journal for Pediatric and Congenital Heart Surgery, Mar 25, 2014

Cortriatriatum with Raghib&am... 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.

World Journal for Pediatric and Congenital Heart Surgery, Mar 1, 2022

Background: In this prospective randomized controlled trial, we compared the standard del Nido ca... more Background: In this prospective randomized controlled trial, we compared the standard del Nido cardioplegia solution (SDN) with the modified del Nido cardioplegia solution (MDN) in which the base solution was the plain Ringer solution. Methods: A total of 80 patients aged < 12 years undergoing intracardiac repair of Tetralogy of Fallot were randomized into SDN (n = 39) or MDN (n = 41) groups. The primary outcome was a change in cardiac index (CI). Secondary outcomes were ventricular arrhythmias after the release of aortic-cross clamp, postoperative inotropic score (IS), time to peripheral rewarming, duration of mechanical ventilation, intensive care unit (ICU) length of stay, and hospital length of stay, and electron microscopic differences between the 2 groups. Cardiac Troponin-I, inflammatory markers tumor necrosis factor-α (TNF-α), and interleukin-L (IL-6) were measured. Results: Applying the noninferiority confidence interval approach, the difference between the changes in CI between the 2 groups was −0.093 L/min/m2 (95% CI: −0.46-0.27 L/min/m2) which was within the noninferiority threshold of −0.5 indicating that CI was similar in both SDN and MDN. Ventricular arrhythmias postclamp release ( P = .91), IS ( P = .09), duration of mechanical ventilation ( P = .27), ICU length of stay ( P = .50), hospital length of stay ( P = .57), IL-6 ( P = .19), TNF-α ( P = .17), Troponin-I ( P = .15), electron microscopy changes ( P > .05) were not different between groups. Conclusion: MDN was shown to be noninferior to the SDN cardioplegia in terms of preservation of cardiac index. In addition, other metrics indicative of myocardial protection were similar between groups. In developing nations where SDN is not available or is expensive, MDN cardioplegia is an acceptable alternative.

Annals of Pediatric Cardiology, 2023

Journal of Cardiac Surgery, Sep 19, 2019

The commonly used technique to facilitate intracardiac exposure during transatrial repair of tetr... more The commonly used technique to facilitate intracardiac exposure during transatrial repair of tetralogy of fallot involves considerable retraction of the tricuspid valve using retractors. We describe an alternative surgical technique in which it is possible to dispense away with the retractors. The advantages of such a technique are discussed.

Journal of Cardiac Surgery, Jun 30, 2013

We report a 3-year-old patient with tetralogy of Fallot (TOF), dextrocardia, situs inversus (SI),... more We report a 3-year-old patient with tetralogy of Fallot (TOF), dextrocardia, situs inversus (SI), and total anomalous pulmonary venous return. This combination of anomalies is extremely unusual. The management is discussed and the literature is reviewed.

Journal of Cardiac Surgery, Jul 28, 2013

Superior cavopulmonary anastomosis and total cavopulmonary anastomosis are the procedures of choi... more Superior cavopulmonary anastomosis and total cavopulmonary anastomosis are the procedures of choice for the management of patients with a functionally univentricular heart. We review the various indications, sites, advantages, and complications of a systemic to pulmonary artery shunt after the creation of superior cavopulmonary anastomosis. Systemic pulmonary artery shunt may be useful as a palliative strategy in patients who have hypoxemia and completion of total cavopulmonary anastomosis is not feasible.

Indian Journal of Thoracic and Cardiovascular Surgery, Dec 1, 2012

ABSTRACT Introduction Advances in technology have spurred innovations in most surgical discipline... more ABSTRACT Introduction Advances in technology have spurred innovations in most surgical disciplines- including cardiac surgery - directed towards minimizing invasiveness without compromising outcomes. We present our initial experience and learning curve difficulties in performing robotically assisted atrial septal defect closure in an adult population. Patients and methods Over a 4 year period between February 2008 to January 2012, we operated upon 52 patients with secundum type of Atrial Septal Defect (ASD), using the daVinci robotic system. All operations were done with peripheral cardiopulmonary bypass and direct transthoracic access to aorta for cardioplegia and aortic cross clamping. Mean age of patients was 26.8 years, mean cross-clamp, cardiopulmonary bypass and operating times were 68.4, 121.6 and 178.44 min respectively. In 4 patients, there was conversion – to sternotomy in three and to thoracotomy in one. In all patients, successful closure was confirmed by Trans Esophageal Echocardiography (TEE). Mean Intensive Care Unit (ICU) stay duration was 22.1 h and hospital stay 3.6 days. There was no mortality. In one patient, there was lung parenchymal bleeding necessitating reexploration followed by persistent air leak for 48 h. Conclusions Robotic telemanipulation enables application of endoscopic technology to performing complex intrathoracic operations safely. Patients with simple lesions like ASD who are not candidates for device closure may be offered this surgeon-friendly technology to avoid possible complications of sternotomy and enable faster recovery. Factors like - adapting to telemanipulation, setting up peripheral cardiopulmonary bypass and restricted visibility prolongs both operating times and surgeons’ learning curve but greatly minimises patient morbidity.

World Journal of Cardiovascular Surgery, 2017

Objective: For patients of TOF with pulmonary annular hypoplasia, reconstruction of right ventric... more Objective: For patients of TOF with pulmonary annular hypoplasia, reconstruction of right ventricular outflow tract (RVOT) often requires a trans annular patch (TAP). The present study aims to compare the outcomes of TOF repair using Polytetrafluoroethylene (PTFE) patch versus autologous glutaraldehyde fixed pericardial patch for RVOT reconstruction. Materials and methods: 103 consecutive patients undergoing TOF repair in whom TAP was required were randomized into two groups: Group I (pericardial patch), Group II (PTFE patch). Postoperative outcomes in terms of postoperative heart rhythm, duration of mechanical ventilation, mediastinal and pleural drainage, length of stay in intensive care unit (ICU) and hospital mortality were assessed. A separate team of cardiologists independently evaluated pre-and post-operative gradients across the RVOT, degree of pulmonary insufficiency, right ventricular systolic function. Results: There were no significant differences between the two groups in terms of the incidence of postoperative arrhythmias, duration of mechanical ventilation, length of intensive care unit or hospital stay. The requirement of inotropes was no different in the PTFE patch group as compared with the pericardial patch group (16.84 ± 7.04 vs. 17.90 ± 6.71, median 19 vs. 20, p = 0.825). The re-exploration rate was higher in the PTFE group as compared with the pericardial patch group (6 vs. 1). Postoperative Echocar-diography revealed no differences in the RV systolic function between the two groups before discharge. Conclusion: In patients undergoing TOF repair, using a PTFE patch yields comparable results. However, the efficacy of PTFE will only be established once; mid-term and long-term results How to cite this paper:

Journal of Cardiac Surgery, Dec 17, 2013

Total anomalous pulmonary venous connection can be encountered in patients with a univentricular ... more Total anomalous pulmonary venous connection can be encountered in patients with a univentricular heart and must be addressed to at the time of univentricular palliation. We present an alternative technique of re-channeling of the pulmonary venous return toward the left heart in these patients.

Asian Cardiovascular and Thoracic Annals, Apr 1, 2012

An alternative technique for channeling the pulmonary venous return towards the left atrium in pa... more An alternative technique for channeling the pulmonary venous return towards the left atrium in patients with total anomalous pulmonary venous return to the coronary sinus is described. The advantages of this technique, which avoids the use of patch material and prevents arrhythmias, are discussed.

Journal of Pediatric Hematology Oncology, Sep 9, 2020

Primary intracardiac teratoma is a rare cardiac tumor with few cases reports in neonates and chil... more Primary intracardiac teratoma is a rare cardiac tumor with few cases reports in neonates and children. The authors present a case of an 8-year-old boy diagnosed with a cystic mass within the heart. The mass lesion was originating from the interventricular septum and was obliterating the ventricular chambers. Clinically, the mass was suspected to be a hydatid cyst. Surgical excision of the cyst was done that was confirmed histopathologically as mature teratoma. Although rare, it should be considered in the differential diagnosis of cystic lesions of heart when evaluating mass lesions in the pediatric age group.