Swati Garekar - Academia.edu (original) (raw)

Papers by Swati Garekar

Research paper thumbnail of Clinical Application and Multidisciplinary Assessment of Three Dimensional Printing in Double Outlet Right Ventricle With Remote Ventricular Septal Defect

World journal for pediatric & congenital heart surgery, 2016

Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventric... more Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventricular septal defect (VSD) may present a therapeutic challenge. Echocardiographic imaging of such complex cases does not always provide all of the information required to decide on an operative approach (biventricular or univentricular) and to design an intracardiac baffle to direct left ventricular outflow through the VSD and to the aorta for biventricular repair. A three dimensional (3D) printed model of the heart based upon data derived from computed tomography (CT) or magnetic resonance imaging (MRI) may contribute to a more complete appreciation of the intracardiac anatomy. From April to September 2015, six consecutive patients with DORV and remote VSD underwent CT/MRI scans. Data sets from these studies were used to generate life-size 3D models using a 3D printer. We compared the assessment of 3D printed heart model findings with information obtained from echocardiography, CT, or car...

Research paper thumbnail of MRA-based 3D-printed heart model—an effective tool in the pre-surgical planning of DORV

Research paper thumbnail of Development and Implementation of Pediatric Critical Care Focused Simulation Workshop and Program in India

Research paper thumbnail of Development and Implementation of Pediatric Critical Care Focused Simulation Workshop and Program in India

Research paper thumbnail of Staged pacemaker implantation in a preterm with hydrops fetalis due to complete heart block

Annals of Pediatric Cardiology, 2013

Research paper thumbnail of Neonatal pulmonary artery thrombosis

Annals of Pediatric Cardiology, 2012

Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diag... more Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

Research paper thumbnail of Chapter-14 Cyanotic Congenital Heart Disease

Pediatric Cardiology, 2013

Research paper thumbnail of Is it safe to perform cardiac catheterizations on adults with congenital heart disease in a pediatric catheterization laboratory?

Catheterization and Cardiovascular Interventions, 2005

Objective: To determine the complication rate during the catheterization in adults with congenita... more Objective: To determine the complication rate during the catheterization in adults with congenital heart disease (CHD) in a pediatric catheterization laboratory (PCL). Background: An increasing number of patients with CHD are surviving into adulthood, with diagnostic and interventional cardiac catheterization being essential for the management of their disease. The complication rate during the catheterization of adults with CHD has not been reported. Methods: A retrospective chart review was performed on all adult patients (>18 years) with CHD who underwent diagnostic or interventional catheterization in our PCL within the past 8.5 years. Results: A total of 576 procedures were performed on 436 adult patients (median age 26 years). Complex heart disease was present in 387/576 (67%) procedures. An isolated atrial septal defect or patent foramen ovale was present in 115/576 (20%) procedures, and 51/576 (9%) procedures were performed on patients with structurally normal hearts with arrhythmias. Interventional catheterization was performed in 378/576 (66%) procedures. There were complications during 61/576 (10.6%) procedures; 19 were considered major and 42 minor. Major complications were death (1), ventricular fibrillation (1), hypotension requiring inotropes , atrial flutter , retroperitoneal hematoma, pneumothorax, hemothorax, aortic dissection, renal failure, myocardial ischemia and stent malposition (1 each). The most common minor complications were vascular entry site hematomas and hypotension not requiring inotropes. Procedures performed on patients ≥ 45 years of age had a 19% occurrence of complications overall compared with 9% occurrence rate in patients of age < 45 years (P < 0.01). Conclusions: The complication rate during the catheterization of adults with CHD in a PCL is similar to the complication rate of children with CHD undergoing cardiac catheterization. The older subset of patients are more likely to encounter complications overall. The encountered complications could be handled effectively in the PCL. With screening in place, it is safe to perform cardiac catheterization on most adults with CHD in a PCL. ' 2005 Wiley-Liss, Inc.

Research paper thumbnail of Heat stress response results in increased macrophage inflammatory protein-2 concentration in a lipopolysaccharide-exposed macrophage cell line

Journal of endotoxin research, 2006

Pretreatment with heat confers cardiopulmonary protection in endotoxemic animals. This mechanism ... more Pretreatment with heat confers cardiopulmonary protection in endotoxemic animals. This mechanism may be through suppression of pro-inflammatory mediator production. The objectives of this study were to determine the effect of heat stress on tumor necrosis factor-alpha (TNF-alpha) and macrophage inflammatory protein-2 (MIP-2) in a lipopolysaccharide-exposed macrophage cell line and to study the relationship between TNF-alpha and MIP-2 production. Heat pretreatment resulted in decreased TNF-alpha transcription and translation by lipopolysaccharide-exposed macrophages; and increased MIP-2 concentration without additional effect in transcription. Administration of TNF-alpha antibody prior to exposure to lipopolysaccharide resulted in increased MIP-2 concentration suggesting that TNF-alpha acts to down-regulate MIP-2 production. The mechanism by which heat stress causes an increase in MIP-2 concentration may be secondary to its suppressing effect on TNF-alpha production.

Research paper thumbnail of Horse-shoe lung-rediscovered via volume rendered images

Indian Journal of Radiology and Imaging, 2013

Horseshoe lung, usually associated with pulmonary venolobar syndrome, is a rare congenital anomal... more Horseshoe lung, usually associated with pulmonary venolobar syndrome, is a rare congenital anomaly involving the fusion of the postero-basal segments of the right and left lungs across the midline. The fused segment or the isthmus lies posterior to the pericardium and anterior to the aorta. The associated pulmonary venolobar syndrome involves anomalous systemic arterial supply and anomlaous systemic venous drainage of the right lung. With the advent of MDCT imaging, we can diagnose this rare condition as well all its associated anomalies non-invasively. Volume-rendered techniques greatly simplify the complex anatomy and provide easy understanding of the same.

Research paper thumbnail of Artery Conduit Stenosis? Is Stent Placement Effective for Palliation of Right Ventricle to Pulmonary

This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete sten... more This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete stenosis using predefined criteria.

Research paper thumbnail of Neonatal Supraventricular Tachycardia (SVT)

Research paper thumbnail of Is Stent Placement Effective for Palliation of Right Ventricle to Pulmonary Artery Conduit Stenosis?

Journal of the American College of Cardiology, 2007

This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete sten... more This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete stenosis using predefined criteria.

Research paper thumbnail of 1171-200 Real-time three-dimensional echocardiographic evaluation of global and regional left ventricular systolic function in young patients paced for congenital complete heart block

Journal of the American College of Cardiology, 2004

Fetal arrhythmias are associated with congestive heart failure and development of fetal hydrops, ... more Fetal arrhythmias are associated with congestive heart failure and development of fetal hydrops, which may result in neurological morbidity and mortality. Limited data exists on the long-term outcome of hydropic fetuses. Methods: A retrospective study on cognitive and neurological functioning of 16 infants, aged 0,5 to 12 years, who experienced fetal arrhythmias complicated by hydrops. Results: Seven fetuses had supraventricular tachycardia, 3 had atrial flutter, 1 had ventricular tachycardia and 5 had congenital complete atrioventricular block (CCAVB). Mean GA at birth was 35 weeks and 5 days. Nine fetuses with tachycardia converted to sinus rhythm in a mean time of 7,9 days; resolution of hydrops was achieved in 6 of these patients in a mean time of 7,4 days. Neonatal cranial ultrasound was normal in 7 infants and all but one of these were normal at follow-up: one infant showed a focal thalamic infarction, first seen by the end of the first week, and developed multiple cerebral lesions as a result of a malignant LQTS and died at the age of 2 years. Five infants had flaring on neonatal cranial ultrasound, one associated with a subependymal pseudocyst, and one with calcifications due to a congenital CMV infection. Two of these infants were normal at follow-up, one died two days after birth as a result of withdrawal of therapy, and one infant showed mild global delay. One infant showed evidence of a parenchymal haemorrhage of antenatal onset, presenting as a unilateral porencephalic cyst. He developed a mild hemiplegia with normal cognition. Three infants with CCAVB without cranial ultrasounds were normal at follow-up. Conclusions: Fetal arrhythmias complicated by hydrops are thought to predispose the unborn child to neurological damage. However, in this series 13 out of 16 infants were neurologically normal. Prognosis seems particularly good in case of successful treatment of tachycardia, delivery at term, and in case of CCAVB. Initiation of therapy should not be withheld or delayed on the assumption of poor neurological outcome.

Research paper thumbnail of Heat Stress Induces MIP-2 Production in Monocytes

Critical Care Medicine, 1999

Research paper thumbnail of Electrocardiogram Basics for the Busy Pediatrician

Clinical Pediatrics, 2006

Research paper thumbnail of Is it safe to perform cardiac catheterizations on adults with congenital heart disease in a pediatric catheterization laboratory?

Catheterization and Cardiovascular Interventions, 2005

The user has requested enhancement of the downloaded file. All in-text references underlined in b... more The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately.

Research paper thumbnail of Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: A multi-institutional study

Catheterization and Cardiovascular Interventions, 2007

Background: We report a multi-institutional experience with intravascular stenting (IS) for treat... more Background: We report a multi-institutional experience with intravascular stenting (IS) for treatment of coarctation of the aorta. Methods and Results: Data was collected retrospectively by review of medical records from 17 institutions. The data was broken down to prior to 2002 and after 2002 for further analysis. A total of 565 procedures were performed with a median age of 15 years (mean ¼ 18.1 years). Successful reduction in the post stent gradient (<20 mm Hg) or increase in post stent coarctation to descending aorta (DAo) ratio of >0.8 was achieved in 97.9% of procedures. There was significant improvement (P < 0.01) in pre versus post stent coarctation dimensions (7.4 mm 6 3.0 mm vs. 14.3 6 3.2mm), systolic gradient (31.6 mm Hg 6 16.0 mm Hg vs. 2.7 mm Hg 6 4.2 mm Hg) and ratio of the coarctation segment to the DAo (0.43 6 0.17 vs. 0.85 6 0.15). Acute complications were encountered in 81/565 (14.3%) procedures. There were two procedure related deaths. Aortic wall complications included: aneurysm formation (n ¼ 6), intimal tears (n ¼ 8), and dissections (n ¼ 9). The risk of aortic dissection increased significantly in patients over the age of 40 years. Technical complications included stent migration (n ¼ 28), and balloon rupture (n ¼ 13). Peripheral

Research paper thumbnail of Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

Catheterization and Cardiovascular Interventions, 2007

Background: We report a multiinstitutional study on intermediate-term outcome of intravascular st... more Background: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up.

Research paper thumbnail of Retroaortic left innominate vein - Incidence, association with congenital heart defects, embryology, and clinical significance

Annals of Pediatric Cardiology, 2008

In a retrospective analysis of echocardiograms, the incidence of retroaortic innominate vein was ... more In a retrospective analysis of echocardiograms, the incidence of retroaortic innominate vein was found to be 0.55% amongst children with congenital heart disease. It was most commonly associated with tetralogy of Fallot and right aortic arch.

Research paper thumbnail of Clinical Application and Multidisciplinary Assessment of Three Dimensional Printing in Double Outlet Right Ventricle With Remote Ventricular Septal Defect

World journal for pediatric & congenital heart surgery, 2016

Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventric... more Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventricular septal defect (VSD) may present a therapeutic challenge. Echocardiographic imaging of such complex cases does not always provide all of the information required to decide on an operative approach (biventricular or univentricular) and to design an intracardiac baffle to direct left ventricular outflow through the VSD and to the aorta for biventricular repair. A three dimensional (3D) printed model of the heart based upon data derived from computed tomography (CT) or magnetic resonance imaging (MRI) may contribute to a more complete appreciation of the intracardiac anatomy. From April to September 2015, six consecutive patients with DORV and remote VSD underwent CT/MRI scans. Data sets from these studies were used to generate life-size 3D models using a 3D printer. We compared the assessment of 3D printed heart model findings with information obtained from echocardiography, CT, or car...

Research paper thumbnail of MRA-based 3D-printed heart model—an effective tool in the pre-surgical planning of DORV

Research paper thumbnail of Development and Implementation of Pediatric Critical Care Focused Simulation Workshop and Program in India

Research paper thumbnail of Development and Implementation of Pediatric Critical Care Focused Simulation Workshop and Program in India

Research paper thumbnail of Staged pacemaker implantation in a preterm with hydrops fetalis due to complete heart block

Annals of Pediatric Cardiology, 2013

Research paper thumbnail of Neonatal pulmonary artery thrombosis

Annals of Pediatric Cardiology, 2012

Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diag... more Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

Research paper thumbnail of Chapter-14 Cyanotic Congenital Heart Disease

Pediatric Cardiology, 2013

Research paper thumbnail of Is it safe to perform cardiac catheterizations on adults with congenital heart disease in a pediatric catheterization laboratory?

Catheterization and Cardiovascular Interventions, 2005

Objective: To determine the complication rate during the catheterization in adults with congenita... more Objective: To determine the complication rate during the catheterization in adults with congenital heart disease (CHD) in a pediatric catheterization laboratory (PCL). Background: An increasing number of patients with CHD are surviving into adulthood, with diagnostic and interventional cardiac catheterization being essential for the management of their disease. The complication rate during the catheterization of adults with CHD has not been reported. Methods: A retrospective chart review was performed on all adult patients (>18 years) with CHD who underwent diagnostic or interventional catheterization in our PCL within the past 8.5 years. Results: A total of 576 procedures were performed on 436 adult patients (median age 26 years). Complex heart disease was present in 387/576 (67%) procedures. An isolated atrial septal defect or patent foramen ovale was present in 115/576 (20%) procedures, and 51/576 (9%) procedures were performed on patients with structurally normal hearts with arrhythmias. Interventional catheterization was performed in 378/576 (66%) procedures. There were complications during 61/576 (10.6%) procedures; 19 were considered major and 42 minor. Major complications were death (1), ventricular fibrillation (1), hypotension requiring inotropes , atrial flutter , retroperitoneal hematoma, pneumothorax, hemothorax, aortic dissection, renal failure, myocardial ischemia and stent malposition (1 each). The most common minor complications were vascular entry site hematomas and hypotension not requiring inotropes. Procedures performed on patients ≥ 45 years of age had a 19% occurrence of complications overall compared with 9% occurrence rate in patients of age < 45 years (P < 0.01). Conclusions: The complication rate during the catheterization of adults with CHD in a PCL is similar to the complication rate of children with CHD undergoing cardiac catheterization. The older subset of patients are more likely to encounter complications overall. The encountered complications could be handled effectively in the PCL. With screening in place, it is safe to perform cardiac catheterization on most adults with CHD in a PCL. ' 2005 Wiley-Liss, Inc.

Research paper thumbnail of Heat stress response results in increased macrophage inflammatory protein-2 concentration in a lipopolysaccharide-exposed macrophage cell line

Journal of endotoxin research, 2006

Pretreatment with heat confers cardiopulmonary protection in endotoxemic animals. This mechanism ... more Pretreatment with heat confers cardiopulmonary protection in endotoxemic animals. This mechanism may be through suppression of pro-inflammatory mediator production. The objectives of this study were to determine the effect of heat stress on tumor necrosis factor-alpha (TNF-alpha) and macrophage inflammatory protein-2 (MIP-2) in a lipopolysaccharide-exposed macrophage cell line and to study the relationship between TNF-alpha and MIP-2 production. Heat pretreatment resulted in decreased TNF-alpha transcription and translation by lipopolysaccharide-exposed macrophages; and increased MIP-2 concentration without additional effect in transcription. Administration of TNF-alpha antibody prior to exposure to lipopolysaccharide resulted in increased MIP-2 concentration suggesting that TNF-alpha acts to down-regulate MIP-2 production. The mechanism by which heat stress causes an increase in MIP-2 concentration may be secondary to its suppressing effect on TNF-alpha production.

Research paper thumbnail of Horse-shoe lung-rediscovered via volume rendered images

Indian Journal of Radiology and Imaging, 2013

Horseshoe lung, usually associated with pulmonary venolobar syndrome, is a rare congenital anomal... more Horseshoe lung, usually associated with pulmonary venolobar syndrome, is a rare congenital anomaly involving the fusion of the postero-basal segments of the right and left lungs across the midline. The fused segment or the isthmus lies posterior to the pericardium and anterior to the aorta. The associated pulmonary venolobar syndrome involves anomalous systemic arterial supply and anomlaous systemic venous drainage of the right lung. With the advent of MDCT imaging, we can diagnose this rare condition as well all its associated anomalies non-invasively. Volume-rendered techniques greatly simplify the complex anatomy and provide easy understanding of the same.

Research paper thumbnail of Artery Conduit Stenosis? Is Stent Placement Effective for Palliation of Right Ventricle to Pulmonary

This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete sten... more This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete stenosis using predefined criteria.

Research paper thumbnail of Neonatal Supraventricular Tachycardia (SVT)

Research paper thumbnail of Is Stent Placement Effective for Palliation of Right Ventricle to Pulmonary Artery Conduit Stenosis?

Journal of the American College of Cardiology, 2007

This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete sten... more This study was designed to evaluate the outcome of stent placement (SP) for conduit discrete stenosis using predefined criteria.

Research paper thumbnail of 1171-200 Real-time three-dimensional echocardiographic evaluation of global and regional left ventricular systolic function in young patients paced for congenital complete heart block

Journal of the American College of Cardiology, 2004

Fetal arrhythmias are associated with congestive heart failure and development of fetal hydrops, ... more Fetal arrhythmias are associated with congestive heart failure and development of fetal hydrops, which may result in neurological morbidity and mortality. Limited data exists on the long-term outcome of hydropic fetuses. Methods: A retrospective study on cognitive and neurological functioning of 16 infants, aged 0,5 to 12 years, who experienced fetal arrhythmias complicated by hydrops. Results: Seven fetuses had supraventricular tachycardia, 3 had atrial flutter, 1 had ventricular tachycardia and 5 had congenital complete atrioventricular block (CCAVB). Mean GA at birth was 35 weeks and 5 days. Nine fetuses with tachycardia converted to sinus rhythm in a mean time of 7,9 days; resolution of hydrops was achieved in 6 of these patients in a mean time of 7,4 days. Neonatal cranial ultrasound was normal in 7 infants and all but one of these were normal at follow-up: one infant showed a focal thalamic infarction, first seen by the end of the first week, and developed multiple cerebral lesions as a result of a malignant LQTS and died at the age of 2 years. Five infants had flaring on neonatal cranial ultrasound, one associated with a subependymal pseudocyst, and one with calcifications due to a congenital CMV infection. Two of these infants were normal at follow-up, one died two days after birth as a result of withdrawal of therapy, and one infant showed mild global delay. One infant showed evidence of a parenchymal haemorrhage of antenatal onset, presenting as a unilateral porencephalic cyst. He developed a mild hemiplegia with normal cognition. Three infants with CCAVB without cranial ultrasounds were normal at follow-up. Conclusions: Fetal arrhythmias complicated by hydrops are thought to predispose the unborn child to neurological damage. However, in this series 13 out of 16 infants were neurologically normal. Prognosis seems particularly good in case of successful treatment of tachycardia, delivery at term, and in case of CCAVB. Initiation of therapy should not be withheld or delayed on the assumption of poor neurological outcome.

Research paper thumbnail of Heat Stress Induces MIP-2 Production in Monocytes

Critical Care Medicine, 1999

Research paper thumbnail of Electrocardiogram Basics for the Busy Pediatrician

Clinical Pediatrics, 2006

Research paper thumbnail of Is it safe to perform cardiac catheterizations on adults with congenital heart disease in a pediatric catheterization laboratory?

Catheterization and Cardiovascular Interventions, 2005

The user has requested enhancement of the downloaded file. All in-text references underlined in b... more The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately.

Research paper thumbnail of Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: A multi-institutional study

Catheterization and Cardiovascular Interventions, 2007

Background: We report a multi-institutional experience with intravascular stenting (IS) for treat... more Background: We report a multi-institutional experience with intravascular stenting (IS) for treatment of coarctation of the aorta. Methods and Results: Data was collected retrospectively by review of medical records from 17 institutions. The data was broken down to prior to 2002 and after 2002 for further analysis. A total of 565 procedures were performed with a median age of 15 years (mean ¼ 18.1 years). Successful reduction in the post stent gradient (<20 mm Hg) or increase in post stent coarctation to descending aorta (DAo) ratio of >0.8 was achieved in 97.9% of procedures. There was significant improvement (P < 0.01) in pre versus post stent coarctation dimensions (7.4 mm 6 3.0 mm vs. 14.3 6 3.2mm), systolic gradient (31.6 mm Hg 6 16.0 mm Hg vs. 2.7 mm Hg 6 4.2 mm Hg) and ratio of the coarctation segment to the DAo (0.43 6 0.17 vs. 0.85 6 0.15). Acute complications were encountered in 81/565 (14.3%) procedures. There were two procedure related deaths. Aortic wall complications included: aneurysm formation (n ¼ 6), intimal tears (n ¼ 8), and dissections (n ¼ 9). The risk of aortic dissection increased significantly in patients over the age of 40 years. Technical complications included stent migration (n ¼ 28), and balloon rupture (n ¼ 13). Peripheral

Research paper thumbnail of Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

Catheterization and Cardiovascular Interventions, 2007

Background: We report a multiinstitutional study on intermediate-term outcome of intravascular st... more Background: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up.

Research paper thumbnail of Retroaortic left innominate vein - Incidence, association with congenital heart defects, embryology, and clinical significance

Annals of Pediatric Cardiology, 2008

In a retrospective analysis of echocardiograms, the incidence of retroaortic innominate vein was ... more In a retrospective analysis of echocardiograms, the incidence of retroaortic innominate vein was found to be 0.55% amongst children with congenital heart disease. It was most commonly associated with tetralogy of Fallot and right aortic arch.