Browsing by Author "Mahadevan, KK"

Now showing 1 - 7 of 7
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    BALLOON MITRAL VALVOTOMY FOR PATIENTS WITH MITRAL STENOSIS IN ATRIAL FIBRILLATION: IMMEDIATE AND LONG-TERM RESULTS
    (JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011) Nair, KKM; Sivadasanpillai, H; Thajudeen, A; Tharakan, JM; Titus, T; Valaparambil, A; Sivasubramonian, S; Mahadevan, KK; Namboodiri, N; Sasidharan, B; Ganapathy, S
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    Comparative study on safety, efficacy, and midterm results of balloon mitral valvotomy performed with triple lumen and double lumen mitral valvotomy catheters
    (Cardiovasc Interv., 2012-11) Nair, KKM; Pillai, H S; Thajudeen, A; Tharakan, J; Titus, T; Valaparambil, A; Sivasubramonian, S; Mahadevan, KK; Namboodiri, N; Sasidharan, B; Ganapathi, S
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    Comparative Study on Safety, Efficacy, and Midterm Results of Balloon Mitral Valvotomy Performed With Triple Lumen and Double Lumen Mitral Valvotomy Catheters
    (CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2012) Nair, KKM; Pillai, HS; Thajudeen, A; Tharakan, J; Titus, T; Valaparambil, A; Sivasubramonian, S; Mahadevan, KK; Namboodiri, N; Sasidharan, B; Ganapathi, S
    Background: The triple lumen Inoue balloon is routinely used for Balloon Mitral Valvotomy (BMV) in India. Its major limitation is the high cost. The double lumen Accura balloon is less expensive, making it an attractive alternative in the developing countries. The study was meant to assess the safety, efficacy and midterm results of Accura balloon with respect to the Inoue balloon. Patients and Methods: 816 consecutive patients, who underwent elective BMV in this Institute from 1997 to 2003, were included in the study. The data of 487 patients who underwent BMV with Accura balloon was compared with 329 patients who underwent BMV with Inoue balloon. The clinical, echocardiographic, and hemodynamic data of these patients were analyzed retrospectively to assess the safety and efficacy of Accura balloon with respect to the Inoue balloon. Results: Immediate procedural success (93.9% in Inoue group and 91.6% in Accura group p. NS) and complications (6.6% in Inoue group and 5.6% in Accura group p. NS) were comparable between the study groups. The two study population had similar restenosis rate and events at 1 year after BMV. Both balloons could be reused multiple times without compromising on the safety and effectiveness. Accura balloons were less costly than Inoue balloon. The reusability with Accura was slightly more and found to be more cost-effective. Conclusions: Both Accura and Inoue balloon mitral valvotomy balloons are effective in providing relief from hemodynamically significant mitral stenosis in terms of gain in valve area and reduction in trans mitral gradient. Both groups have similar procedural success and complication rates, restenosis, and follow-up events at 1 year. Both balloons could be reused multiple times and Accura balloon is found to be more cost effective. (C) 2012 Wiley Periodicals Inc.
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    Large Esophageal Hematoma Following Transesophageal Echocardiography-Guided Device Closure of Atrial Septal Defect
    (ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2016) Sasikumar, D; Mahadevan, KK
    A 47-year-old woman with a large ostium secundum atrial septal defect (ASD) and severe pulmonary artery hypertension underwent device closure of ASD under transesophageal echocardiography guidance. She developed a massive esophageal hematoma which was diagnosed 4 days after the procedure. The use of dual antiplatelets after the device closure further aggravated the hematoma. As the patient remained stable and the site of leak could not be identified by contrast studies, she was managed conservatively with nil per mouth, broad-spectrum antibiotics, and continuous nasogastric aspiration. We were faced with the risk of thromboembolism after stopping antiplatelets versus the risk of increasing peri-esophageal hematoma if they were continued. With careful monitoring for thrombus formation on the device, the antiplatelets were stopped and the hematoma resolved. The hematoma resolved by 10 days, and the antiplatelets were restarted gradually. Iatrogenic esophageal injury is an important cause of esophageal perforation, which is a condition with high mortality and morbidity. Esophageal perforation following device closure of ASD is particularly challenging as the scenario is worsened by the use of antiplatelets and they have to be discontinued with the attendant risk of thromboembolism. Mini-Abstract A lady underwent device closure of atrial septal defect (ASD) under transesophageal echocardiography guidance. A massive esophageal hematoma was diagnosed 4 days after the procedure, which was aggravated by the use of dual antiplatelets. She was managed conservatively. With careful monitoring, the antiplatelets were stopped and the hematoma resolved by 10 days. The antiplatelets were restarted gradually. Esophageal perforation following device closure of ASD is particularly challenging as the scenario is worsened by the use of antiplatelets, and they have to be discontinued with the attendant risk of thromboembolism.
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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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    Self-Repositioning of an Embolized Patent Ductus Arteriosus Device-A Nightmare Turned into Sweet Dreams
    (CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2015) Subramanian, V; Mahadevan, KK; Sivasubramonian, S
    A 7-month-old boy was admitted for the device closure of symptomatic patent ductus arteriosus (PDA) with moderate pulmonary hypertension. The PDA measured 4.2 mm with adequate ampulla. It was closed with an 8-6 mm Heart R device from pulmonary artery (PA) end. Post extubation, the device embolized to proximal descending thoracic aorta just distal to PDA ampulla. While attempting to snare from the venous side, the device self-repositioned to PDA. It was stable thereafter and patient was discharged after 2 days. We report a complication, which got self-corrected. (c) 2014 Wiley Periodicals, Inc.
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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.