Browsing by Author "Tharakan, JM"

Now showing 1 - 16 of 16
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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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    Brugada syndrome
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2005) Harikrishnan, S; Dora, SK; Tharakan, JM
    Two siblings with features of Brugada syndrome are reported. One of them had permanent pacemaker implantation elsewhere where he was evaluated for recurrent syncope and diagnosed to have tri-fascicular block. He continued to have syncopal episodes and subsequently detected to have runs of polymorphic ventricular tachycardia picked up on a routine ECG. His sibling also was found to have features of Brugada syndrome. (c) 2004 Published by Elsevier Ireland Ltd.
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    Comparison of percutaneous transmitral commissurotomy with Inoue balloon technique and metallic commissurotomy: Immediate and short-term follow-up results of a randomized study
    (AMERICAN HEART JOURNAL, 2002)
    Background The Inoue balloon technique for mitral commissurotomy is well established and carried out worldwide. Metallic commissurotomy is reported to be a cheaper and effective alternative to balloon mitral commissurotomy.Methods One hundred patients were randomized into 2 groups to undergo percutaneous transmitral commissurotomy (PTMC) by means of the Inoue balloon technique (IBMC, n = 49) or metallic commissurotomy (PMMC, n = 51). Patients were crossed over to the other technique when the initial technique was a failure. Success of valvotomy, procedure-related complications, and follow-up events of the 2 techniques were compared.Results Basal echocardiographic and hemodynamic data were similar in both groups. Procedural success was similar in both groups: 45 of 49 procedures (91.8%) in the IBMC group, compared with 46 of 51 procedures (90.18%) in the PMMC group (P = 1.0). Crossover was also comparable, with I occurring in the IBMC group, compared with 3 in the PMMC group. Complications such as cardiac tamponade and mitral regurgitation (requiring or not requiring mitral valve replacement) were similar in both groups, with 3 complications in the IBMC group, compared with 4 complications in the PMMC group (P =.29). After a follow-up period of approximately 4 months, both groups had similar event rates and comparable hemodynamic parameters (P = not significant).Conclusions Both IBMC and PMMC are successful means of providing relief from severe mitral stenosis with a gain in valve area and reduction in transmitral gradient. Both techniques have similar procedural success, complication rates, and follow-up events.
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    Congenital bilateral aplasia of external iliac arteries
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2001) Harikrishnan, S; Krishnamoorthy, KM; Tharakan, JM
    A child with bilateral aplasia of external iliac arteries with normal internal iliac arteries, demonstrated by vascular Doppler and digital subtraction angiography is presented. Popliteal artery is reformed by collaterals. This anomaly is extremely rare. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
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    Coronary artery fistulae from single coronary artery in a patient with rheumatic mitral stenosis
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2001) Harikrishnan, S; Bimal, F; Tharakan, JM
    Here we report coronary artery fistulae (CAF) arising from a single coronary artery in a patient with rheumatic mitral stenosis. A 62-year-old woman underwent a coronary angiogram prior to mitral valve replacement (MVR). The left coronary artery angiogram showed the right coronary artery arising from the left anterior descending coronary artery. From the distal left circumflex artery, two CAF were seen draining into left atrium. The haemodynamically insignificant fistulae were left alone and patient underwent MVR. Such an association has not been reported so far. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
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    Double right coronary artery
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2001) Harikrishnan, S; Bhat, A; Tharakan, JM
    Many of the primary congenital coronary anomalies are hemodynamically insignificant. Here we report one such anomaly - a rare one, Double Right Coronary Artery. A 52-year-old woman underwent Coronary Angiogram prior to Mitral valve replacement. RCA injection showed filling of two separately originating RCAs, coursing towards the right atrio-ventricular groove. The superior RCA, after conus artery and 2 Right Ventricular branches, descended! beyond the acute margin of the heart and terminated as Posterior Descending Coronary Artery (PDA). The inferior RCA, after one small RV branch ended at the crux, as PDA and a small Postero-lateral Branch. Both RCAs and the left coronary artery system were free of any disease. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
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    Intermediate-term follow-up results of percutaneous transvenous mitral commissurotomy using metallic commissurotome: Single-center experience
    (AMERICAN JOURNAL OF CARDIOLOGY, 2003) Harikrishnan, S; Bhat, A; Tharakan, JM; Titus, T
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    Intracranial aneurysms, coronary aneurysms and descending aortic coarctation - unreported association
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2005) Harikrishnan, S; Stigimon, J; Tharakan, JM
    Rare association of coronary artery aneurysms with intra cranial aneurysms is reported. Also, association of abdominal aortic coarctation with intracranial aneurysms is rare. A 70-year-old female presented with subarachnoid hemorrhage secondary to rupture of intracranial aneurysm. On evaluation, she was found to have intracranial aneurysms in the vertebral and basilar artery, coronary aneurysms and descending thoracic aortic coarctation. This association is unreported. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
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    Left atrial myxoma presenting as acute myocardial infarction in a child
    (CARDIOLOGY, 2003) Harikrishnan, S; KrishnaManohar, SR; Kumar, RK; Tharakan, JM
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    Novel deletions in MYH7 and MYBPC3 identified in Indian families with familial hypertrophic cardiomyopathy
    (JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY, 2003) Waldmuller, S; Sakthivel, S; Saadi, AV; Selignow, C; Rakesh, PG; Golubenko, M; Joseph, PK; Padmakumar, R; Richard, P; Schwartz, K; Tharakan, JM; Rajamanickam, C; Vosberg, HP
    Mutations causing familial hypertrophic cardiomyopathy (HCM) have been described in at least 11 genes encoding cardiac sarcomeric proteins. In this study. three previously unknown deletions have been identified in the human cardiac genes coding for beta-myosin heavy chain (MYH7 on chromosome 14) and myosin-binding protein-C (MYBPC3 on chromosome 11). In family MM, a 3-by deletion in MYH7 was detected to be associated with loss of glutamic acid in position 927 (DeltaE927) of the myosin rod. In two other families (HH and NP, related by a common founder) a 2-bp loss in codon 453 (exon 16) of MYBPC3 was identified as the presumable cause of a translation reading frame shift. Taken together 15 living mutation carriers were investigated. Six deceased family members (with five cases of premature sudden cardiac death (SCD) in families MM and NP) were either obligate or suspected mutation carriers. In addition to these mutations a 25-bp deletion in intron 32 of MYBPC3 was identified in family MM (five carriers) and in a fourth family (MiR, one HCM patient, three deletion carriers). In agreement with the loss of the regular splicing branch point in the altered intron 32, a splicing deficiency was observed in an exon trapping experiment using MYBPC3 exon 33 as a test substrate. Varying disease profiles assessed using standard clinical, ECG and echocardiographic procedures in conjunction with mutation analysis led to the following conclusions: (1) In family MM the DeltaE927 deletion in MYH7 was assumed to be associated with complete penetrance. Two cases of reported SCD might have been related to this mutation. (2) The two families, HH and NP, distantly related by a common founder, and both suffering from a 2-bp deletion in exon 16 of MYBPC3 differed in their average phenotypes. In family NP. four cases of cardiac death were documented, whereas no cardiac-related death was reported from family HH. These results support the notion that mutations in HCM genes may directly determine disease penetrance and severity; however, a contribution of additional, unidentified factors (genes) to the HCM phenotype can-at least in some cases-not be excluded. (3) The deletion in intron 32 of MYBPC3 was seen in two families, but in both its relation to disease was not unequivocal. In addition, this deletion was observed in 16 of 229 unrelated healthy individuals of the population of the South Indian states of Kerala and Tamil Nadu. It was not seen in 270 Caucasians from Russia and western Europe. Hence. it is considered to represent a regional genetic polymorphism restricted to southern India. The association of the deletion with altered splicing in transfected cells suggests that this deletion may create a "modifying gene", which is per se not or only rarely causing HCM. but which may enhance the phenotype of a mutation responsible for disease. (C) 2003 Elsevier Science Ltd. All rights reserved.
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    Novel mutations in MYH7 and MYPBC3 of an Indian family causing hypertrophic cardiomyopathy
    (JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY, 2001)
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    Percutaneous coil closure of recanalised anomalous origin of left coronary artery from pulmonary artery
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2002) Bimal, F; Harikrishnan, S; Titus, T; Tharakan, JM
    An asymptomatic boy underwent surgical correction of anomalous origin of left coronary artery from pulmonary artery (ALCAPA) with trans-pulmonary artery interruption and saphenous vein grafting to left anterior descending coronary artery. He developed a shunt through the re-canalised pulmonary artery end of the ALCAPA which was successfully embolised using a detachable PDA coil delivered into the left main coronary artery from the pulmonary artery. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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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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    Post myocardial infarction ventricular septal rupture in a patient with single coronary artery
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2002) Kumar, VKA; Harikrishnan, S; Tharakan, JM
    A 52-year-old male developed ventricular septal rupture on the third day after acute anterior wall myocardial infarction. Coronary angiogram showed a single coronary artery (right coronary from left main stem) with significant lesions in left anterior descending and in left circumflex coronary arteries. This association has not been reported so far. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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    Self-blood letting in congestive cardiac failure
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2007) Krishnakumar, N; Hankrishnan, S; Tharakan, JM
    A 33-year-old male with idiopathic restrictive cardiomyopathy had dilated and tortuous veins over both lower limbs and over the scrotum with multiple hyperpigmented scars. He was in the habit of puncturing the veins to let out blood during episodes of worsening of dyspnoea, thereby relieving dyspnoea by decreasing the preload. (c) 2005 Elsevier Ireland Ltd. All rights reserved.