Browsing by Author "Tharakan, J M"

Now showing 1 - 7 of 7
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    A ten-year post-surgical assessment of pulmonary hypertension in adults with patent ductus arteriosus.
    (Indian heart journal, 1996)
    The long-term follow-up was analysed for 25 patients above the age of 12 years who had patent ductus arteriosus with severe pulmonary hypertension and had undergone surgical closure. There were 11 males and 14 females (age range 12-27 years; mean 18.6 years). There were 2 early and 2 late deaths. All the 21 survivors were followed up at regular intervals for 8-10 years. They were assessed by haemodynamic study: 13 of the 21 survivors underwent a study 6 months to 1 year after surgery and another 4 patients, 8 years after surgery; 7 patients of the 13 had a second study 8-10 years after surgery. The pulmonary artery systolic and mean pressures regressed to 50% of the preoperative level in the first study for 15 patients, and in the second study 2 patients had further drop in pulmonary artery pressures; however, the pressure levels never reached normal values. The pulmonary vascular resistance did not show a correspondingly significant fall. In conclusion, the ten-year follow-up shows that the patients have benefited by the surgery though the pressures have not come down to normal levels, and that they have to be followed up closely to assess the natural history of residual pulmonary hypertension and pulmonary vascular disease and its effect on their quality of life.
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    Intercoronary communication between right and left coronary artery with bidirectional flow--a rare angiographic finding.
    (Indian heart journal, 2010)
    Intercoronary artery continuity is a rare variant of coronary circulation. Here we report a case where we found an intercoronary communication between the left and the right coronary artery. Right coronary angiogram showed filling of the left coronary artery and the left coronary angiogram showed filling of the distal right coronary artery, demonstrating bidirectional flow. The coronary arteries were free of atherosclerotic occlusive disease. The case is reported for its rarity.
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    Left atrial myxoma-influence of tumour size on electrocardiographic findings.
    (Indian heart journal, 2012)
    OBJECTIVE: The data of 51 patients (33 females) who underwent excision of left atrial (LA) myxoma were retrospectively reviewed for correlation of tumour size and electrocardiographic (ECG) findings.METHODS AND RESULTS: Mean age was 39.1 15 years (range 9-53 years). The LA enlargement (LAE) on ECG was defined by standard criteria. The LAE in ECG in these patients did not correlate with echocardiographic LA dimensions or with the degree of left ventricular (LV) inflow obstruction. But it was found that the presence of LAE in ECG predicted maximum tumour dimension of >5 cm and correlated with the degree of mitral regurgitation (MR). The LAE in ECG disappeared following surgery in 87.5% of patients.CONCLUSION: The LA enlargement on ECG in a patient with LA myxoma signifies larger tumour size or the presence of significant MR but is not necessarily associated with an increased LA size or LV inflow obstruction.
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    Left ventricular thrombi in the presence of normal left ventricular function.
    (Indian heart journal, 2002)
    We report two cases of left ventricular thrombi identified by routine echocardiography in the presence of normal ventricular function to highlight the rarity and clinical significance of this condition. A 14-year-old boy, positive for anticardiolipin and antinuclear antibodies, was found to have a left ventricular thrombus. A 30-year-old male, who presented with a transient ischemic attack, was found to have hypereosinophilic syndrome and a mobile left ventricular thrombus. The thrombi disappeared in both patients after a few days of anticoagulant therapy without symptoms of embolization.
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    Once weekly azithromycin in secondary prevention of rheumatic fever.
    (Indian heart journal, 2012)
    Rheumatic fever and rheumatic heart disease (RHD) are still important problems in developing countries. Secondary prophylaxis which is the most cost-effective method in preventing recurrences of rheumatic fever is fraught with problems of drug compliance. The utility of 500 mg once weekly azithromycin (AZT), an orally effective long-acting antibiotic was evaluated against oral penicillin (phenoxy methyl penicillin 250 mg twice daily) in this study. Forty-eight consecutive patients (44% males, mean age 29.4 years) with established RHD were randomised into two groups-26 patients received AZT and 22 received oral penicillin. Patients were evaluated at randomisation, at 1 month, 3 months, and 6 months, clinically, serologically and by throat swab culture. End points were absence of streptococcal colonisation, infection or fever at the end of 6 months. During the study, 4 patients (15.4%) in the AZT group developed sore throat and fever, had positive throat culture and positive serology indicating streptococcal infection. None satisfied the criteria for rheumatic fever reactivation. None in the oral penicillin group developed streptococcal infection. In conclusion, weekly 500 mg of AZT is not effective in the prevention of streptococcal throat infection compared to oral penicillin therapy in adult patients with established RHD.
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    Peripartum fungal endocarditis of native mitral valve.
    (Indian heart journal, 1998)
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    Saccular coronary aneurysms: angiographic and clinical profile and follow-up of 22 cases.
    (Indian heart journal, 2000)
    Saccular coronary aneurysms are defined as aneurysms with the transverse dimension at least 1.5 times the longitudinal dimension. Out of 3,200 coronary angiograms reviewed, there were 22 patients (20 males) with saccular coronary aneurysms (totalling 25 aneurysms). The morphology of the aneurysms, the extent and severity of associated coronary lesions, the clinical profile and follow-up data of these patients were analysed. Aneurysms were located in left main coronary artery 3 (12%), left anterior descending coronary artery 13 (52%), right coronary artery 5 (20%) and left circumflex 4 (16%). There were 5 large aneurysms (> 15 mm in diameter) (1 in left main coronary artery, 2 each in right coronary artery and left anterior descending coronary artery) averaging 32 mm in size. Fifteen aneurysms had significant coronary artery stenosis located proximal to it, supporting the theory of post-stenotic dilatation as the aetiology of aneurysm formation. Two patients had associated muscle bridges distal to the aneurysm; 20 had atherosclerotic coronary artery disease and one had coronary artery ectasia. Five patients were lost to follow-up, which ranged from 1 year to 19 years (mean 5.3 +/- 4.1 years). No patient had history suggestive of rupture of the aneurysm on follow-up. Two patients had myocardial infarction in the territory of the vessel with the aneurysm. Rest of the patients were in NYHA class I/II. One large right coronary artery aneurysm was subjected to aneurysmectomy due to symptoms of tricuspid valve obstruction. One left main coronary artery aneurysm measuring 12 mm, on follow-up of 19 years increased in size to 45 mm, in addition the patient developed a right coronary artery aneurysm. Coronary risk factor profiles in the 20 patients with atherosclerotic coronary artery disease and aneurysms were similar to age- and sex-matched control population with atherosclerotic coronary artery disease without aneurysms.