Browsing by Author "Sankarkumar, R"

Now showing 1 - 5 of 5
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    A correlative study of the functional class and hemodynamic status following intracardiac repair of tetralogy of Fallot.
    (Indian heart journal, 1991)
    An attempt was made to correlate the NYHA Functional class with the hemodynamic status of 196 patients at an average of 21.2 months following the intracardiac repair of tetralogy of Fallot. 171 patients were in Functional class I (87.2%), 9 in class III (4.5%), 5 in class II (2.5%) and 11 in class IV (5.6%). Right and left heart catheterisation and cardiac angiography revealed the hemodynamic status of these patients to be excellent in 92 (46.4%), good in 37 (18.8%), satisfactory in 6 (3.0%) and unsatisfactory in 61 (31.6%). Whereas all patients in Functional class II, III and IV had unsatisfactory hemodynamic findings, patients in Functional Class I were hemodynamically heterogeneous and included excellent (53.8%), good (21.6%), satisfactory (3.5%) and unsatisfactory (21%) groups. The surgical technique did not seem to determine the functional status. While early reoperation is advisable for patients with functional disability, caution is necessary in considering reoperation for patients in Functional class I who have hemodynamic findings which are classified as unsatisfactory.
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    Chitra heart valve: Results of a multicenter clinical study
    (JOURNAL OF HEART VALVE DISEASE, 2001)
    Background and aim of the study: The Chitra tilting disc valve was developed in India to meet the need for a low-cost cardiac valve. The valve has an integrally machined cobalt-based alloy cage, an ultrahigh molecular-weight polyethylene disc, and a polyester suture ring. An important feature of this valve is its soft closing sound, by virtue of a plastic occluder.Methods: Between December 1990 and January 1995, 306 patients underwent isolated aortic MR, n = 101) or mitral valve replacement (MVR, n = 205) at six institutions in India. The early mortality rate was 6.9% (seven after AVR; 14 after MVR). A total of 285 survivors was followed up until September 1998; total follow up was 1212 patient-years (pt-yr) (AVR, 445 pt-yr; MVR, 767 pt-yr).Results: There were 52 late deaths (4.3%/pt-yr; AVR 2.2%/pt-yr; MVR 5.5%/pt-yr). Thirty-five deaths were valve-related (23 were due to unknown causes). One AVR patient (0.2%/pt-yr) and 12 MVR patients (1.6%/pt-yr) developed valve thrombosis, and embolic episodes occurred in 25 patients (seven after AVR, 1.6%/pt-yr; 18 after MVR, 2.4%/pt-yr). Bleeding events and infectious endocarditis occurred infrequently (AVR 0.9 and 0.7%/pt-yr; MVR 0.4 and 0.5%/pt-yr, respectively). There was no incidence of paravalvular leak or structural dysfunction of the valve. Actuarial survival rates at seven. years were 82.4 +/- 4.0% for AVR and 65.2 +/- 5.0% for MVR. During the same interval, thrombus-free and embolism-free survival after AVR and MVR occurred in 98.9 +/- 1.1% and 94.1 +/- 1.9%, and 92.3 +/- 2.8% and 82.1 +/- 5.7% of patients, respectively. Freedom from all valve-related mortality and morbidity at seven years was 81.5 +/- 4.1% after AVR, and 64.2 +/- 5.1% after MVR.Conclusion: The Chitra valve appears to be safe and to have performance comparable with that of other currently used tilting disc valves. This valve costs substantially less than other valves, and is therefore within reach of a larger subset of Indian patients.
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    Clinical course after mitral valve replacement.
    (Indian heart journal, 1990)
    Two hundred and fifty patients underwent mitral valve replacement for rheumatic valvular disease during a 9-year period from January 1979 to December 1987. A maximum period of follow-up of 10 years and minimum of 1 year was achieved with a mean duration of 4.4 years. The follow-up covered 921 out of a possible 1006 patient-years and was 91.5 per cent complete. Of the patients, 58 (23.2%) were in class II, 145 (58%) were in class III and 47 (18.8%) belonged to class IV. The early mortality for patients in Class II, III and IV was 8.6 per cent, 15.8 per cent and 31.9 per cent respectively and the 3, 5 and 10 years actuarial survival rates for the entire group were 93 per cent, 87 per cent and 70 per cent. The event-free survival rates at the same intervals were 77 per cent, 63 per cent and 57 per cent respectively. Late deaths occurred in 18 (9.5%) of the patients. Twelve of these (66.6%) could be directly ascribed to a valve-related cause.
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    Hemodynamic performance evaluation of TTK Chitra heart valve prosthesis in the aortic position using Doppler echocardiography
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2010) Namboodiri, N; Shajeem, O; Tharakan, J; Sankarkumar, R; Titus, T; Ajitkumar, V; Sivasankaran, S; Krishnamoorthy, KM; Harikrishnan, SP
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    Retrograde cerebral perfusion for treatment of air embolism after valve surgery.
    (Asian cardiovascular & thoracic annals, 2004)
    Air embolism occurred after termination of cardiopulmonary bypass in a 22-year-old man undergoing aortic valve replacement for rheumatic aortic insufficiency. Normothermic retrograde cerebral perfusion was instituted for 5 min at a flow rate of 300-500 mL.min(-1), maintaining internal jugular vein pressure < 25 mmHg. The aortic cannula was declamped intermittently for 5-10 seconds. Mean arterial pressure was kept at 60-70 mmHg. The patient recovered without any neurological deficit.