Browsing by Author "Kumar, A"

Now showing 1 - 8 of 8
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    Coronary artery fistula in children and adults: A review of 25 cases with long-term observations
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 1997) Sunder, KRS; Balakrishnan, KG; Tharakan, JA; Titus, T; Pillai, VRK; Francis, B; Kumar, A; Bhat, A; Shankaran, S
    We studied 25 patients with coronary artery fistula between 1976 and 1994. Age ranged from 1 to 58 years. Twelve patients were symptomatic; seven had dyspnoea, four had angina, one had palpitation and one had syncope. Coronary artery fistula involved right coronary artery in 10, left coronary artery in 11 and both right and left coronary arteries in four. Coronary artery fistula drained into right ventricle in 11, right atrium in nine, pulmonary artery in four and left ventricle in two. The Qp/Qs ranged from 1.0 to 2.6 with a mean of 1.39+/-0.38. Five patients had associated cardiac anomalies. Two had atrial septal defects, one had patent ductus arteriosus, one had atresia of proximal right coronary artery and in one patient, the right coronary artery was arising from left coronary artery. Five patients underwent surgery without any operative mortality. Thirteen patients were followed-up medically for a mean period of 6.1+/-5.1 years. There were no complications related to coronary artery fistula during follow-up. In one patient coronary artery fistula closed spontaneously. Copyright (C) 1997 Elsevier Science Ireland Ltd.
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    Long-term outcome of patients undergoing balloon mitral valvotomy in pregnancy
    (AMERICAN JOURNAL OF CARDIOLOGY, 2005)
    The outcome of 36 patients (mean age 25.8 +/- 4.3 years) who underwent balloon mitral valvuloplasty during pregnancy is described in this report. The procedure was successful in 35 patients (97.2%), with no maternal mortality, and all patients subsequently had symptomatic improvement and uneventful deliveries. The children had normal growth and development at a follow up of 2.8 +/- 3.3 years. Thus, in patients with symptomatic severe mitral stenosis, balloon mitral valvuloplasty is feasible, safe, and effecfive with good long-term outcomes for both the mother and the fetus. (c) 2005 by Excerpta Medica Inc.
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    Percutaneous transmitral commissurotomy in juvenile mitral stenosis - Comparison of long term results of inoue balloon technique and metallic commissurotomy
    (CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2006)
    Objectives: To compare the immediate and long term results of percutaneous mitral valvotomy using metallic commissurotome and Inoue balloon in juvenile mitral stenosis. Background: Inoue balloon technique for mitral commissurotomy (IBMC) is well established and carried out worldwide in the treatment of juvenile mitral stenosis. Percutaneous mitral metallic commissurotomy (PMMC) is reported to be a cheaper and effective alternative to balloon mitral commissurotomy. Methods: Thirty-three patients aged less than 20 years, who underwent PMMC, were compared with 33 age and sex matched control patients who underwent IBMC. Success of valvotomy, procedure related complications, and follow-up events of the two techniques were compared. Results: Basal echocardiographic and hemodynamic data were similar in both groups. Procedural success was similar in both groups, 31/33. Complications like cardiac tamponade and mitral regurgitation (requiring or not requiring mitral valve replacement) were similar in both groups. On follow-up of more than 3 years, both groups had comparable hemodynamic parameters and restenosis rates. Conclusions: Both IBMC and PMMC are successful in providing relief from severe juvenile mitral stenosis in terms of gain in valve area and reduction in transmitral gradient. Both techniques have similar procedural success and complication rates. The long term follow-up results are comparable at follow-up of more than 3 years. (c) 2006 Wiley-Liss, Inc.
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    Percutaneous transvenous mitral commissurotomy using an Inoue balloon in children with rheumatic mitral stenosis
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 1997)
    Percutaneous transvenous mitral commissurotomy(PTMC) using the Inoue technique was performed in 557 patients with rheumatic mitral stenosis. Of these, 107 were children aged 10-18 years (mean+/-SD 14.5+/-2.3). All patients were symptomatic New York Heart Association (NYHA) Class II(n = 78) and Class III (n = 29). All were in sinus rhythm. Following PTMC, the mitral valve area (MVA increased from 0.73+/-0.18 to 1.7+/-0.53 cm(2) (P<0.001). There was a significant fall in mean transmitral gradient from 15.6+/-5.2 to 5.1+/-2.3 mmHg, and in mean pulmonary artery pressure from 41+/-15 to 28.4+/-10 (P<0.001). Cardiac tamponade developed in one patient. One patient developed severe mitral regurgitation requiring emergency mitral valve replacement. Five patients (4.7%) developed moderate mitral regurgitation. There was no mortality or cerebral embolism in any of the children. Four patients (3.7%) had oximetry evidence of atrial septal defect. Mean mitral valve area and transmitral gradient at 14 months mean follow up was 1.68+/-0.4 cm(2) and 6+/-3.5 mmHg, respectively, and were comparable to the immediate post-PTMC results. Two patients (1.8%) developed restenosis. The immediate haemodynamic results in children were compared to 450 adult patients who underwent PTMC in the same period. The outcome was similar in both groups. Children were found to have significantly higher pulmonary artery pressure compared to adults. We found that PTMC using an Inoue balloon is very effective and safe in children, and consider that it should be the procedure of choice for young patients with symptomatic rheumatic mitral stenosis. (C) 1997 Elsevier Science Ireland Ltd.
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    Rebuttal: Percutaneous Valvuloplasty for Mitral Valve Restenosis
    (CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2011) Nair, K; Sivadasanpillai, H; Sivasubramonium, P; Ramachandran, P; Tharakan, JA; Kumar, A; Sivasubramonian, S; Krishnamoorthy, KM; Dora, S
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    Solitary metastasis from occult follicular carcinoma of the thyroid mimicking trigeminal neurinoma - Case report
    (NEUROLOGIA MEDICO-CHIRURGICA, 2001)
    A SO-year-old woman presented with an extremely uncommon case of solitary metastasis from follicular carcinoma of the thyroid, which presented clinically as trigeminal neurinoma, Neuroimaging detected a tumor in the right petrous apex, which was removed surgically. Histological examination showed metastatic follicular carcinoma of the thyroid. However, no primary tumor was detected by various investigations. The tumor recurred twice, and was treated surgically both times. The patient finally agreed to adjuvant therapy for the suspected primary. Radiotherapy was performed followed by complete thyroidectomy, Examination of the gross specimen found the tumor nodule. Clinically significant metastasis can arise from histologically benign and silent follicular thyroid neoplasms.
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    Ventricular septal rupture following myocardial infarction. Long-term survival of patients who did not undergo surgery. Single-centre experience
    (ACTA CARDIOLOGICA, 2005) Pillai, HS; Tharakan, J; Titus, T; Kumar, A; Sivasubramonian, S; Mahadevan, KK; Dora, S; Nair, K; Namboodiri, N
    Long-term survival is rare in patients not undergoing surgery after post-myocardial infarction ventricular septal rupture. We report our experience of seven patients out of 27, who did not undergo surgery and were followed up for a mean period of 2.8years. They were evaluated after a mean period of 2.2 months after infarction in our centre. The septal defects measured 9.8 mms on average and the mean left-to-right shunt ratio was 1.98: L The mean pulmonary artery, right atrial and left ventricular end diastolic pressures were 28.3 +/- 10.6, 4 +/- 3 and 15.8 +/- 4.8 mm Hg, respectively. Only three out of seven patients had LV aneurysm and all patients had single-vessel disease. Smaller defect size, minimal left-to-right shunt and preserved right ventricular function may be the factors responsible for long-term survival.
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    Ventricular septal rupture following myocardial infarction: Clinical, haemodynamic, angiographic profile and long-term outcome
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2007) Harikrishnan, S; Tharakan, J; Titus, T; Kumar, A; Sivasankaran, S; Krishnamoorthy, KM