Browsing by Author "Viswanathan, S"

Now showing 1 - 6 of 6
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    Clinical presentation, management, in-hospital and 90-day outcomes of heart failure patients in Trivandrum, Kerala, India: the Trivandrum Heart Failure Registry
    (Eur J Heart Fail., 2015-07) Harikrishnan, S; Sanjay, G; Anees, T; Viswanathan, S; Vijayaraghavan, G; Bahuleyan, CG; Sreedharan, M; Biju, R; Nair, T; Suresh, K; Rao, AC; Dalus, D; Huffman, MD; Jeemon, P
    Objective To evaluate the presentation, management, and outcomes of patients hospitalized for heart failure (HF) in Trivandrum, India. Methods The Trivandrum Heart Failure Registry (THFR) enrolled consecutive admissions from 13 urban and five rural hospitals in Trivandrum with a primary diagnosis of HF from January to December 2013. Clinical characteristics at presentation, treatment, in-hospital outcomes, and 90-day mortality data were collected. ‘Guideline-based’ medical treatment was defined as the combination of beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and aldosterone receptor blockers in patients with left ventricular systolic dysfunction (LVSD). Results We enrolled 1205 cases (834 men, 69%) into the registry. Mean (standard deviation) age was 61.2 (13.7) years. The most common HF aetiology was ischaemic heart disease (IHD) (72%). Heart failure with preserved ejection fraction (≥45%) constituted 26% of the population. The median hospital stay was 6 days (interquartile range = 4–9 days) with an in-hospital mortality rate of 8.5% (95% confidence interval 6.9–10.0). The 90-day all-cause mortality rate was 2.43 deaths per 1000 person-days (95% confidence interval 2.11–2.78). Guideline-based medical treatment was given to 19% and 25% of patients with LVSD during hospital admission and at discharge, respectively. Older age, lower education, poor ejection fraction, higher serum creatinine, New York Heart Association functional class IV, and suboptimal medical treatment were associated with higher risk of 90-day mortality. Conclusion Patients hospitalized with HF in the THFR were younger, more likely to be men, had a higher prevalence of IHD, reported longer length of hospital stay, and higher mortality compared with published data from other registries. We also identified key areas for improving hospital-based HF medical care in Trivandrum.
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    Collateral venous drainage of solitary functioning left kidney with occluded renal vein following juxtarenal aortic aneurysm repair
    (JOURNAL OF VASCULAR SURGERY-VENOUS AND LYMPHATIC DISORDERS, 2015) Savlania, A; Parameshwarappa, SK; Viswanathan, S; Unnikrishnan, M
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    Dysphagia aortica due to penetrated aortic ulcer
    (EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2015) Savlania, A; Viswanathan, S; Pitchai, S; Unnikrishnan, M
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    Extra-anatomic neo-aorta for adult abdominal aortic coarctation
    (ANZ JOURNAL OF SURGERY, 2014) Savlania, A; Parameshwarappa, SK; Viswanathan, S; Raman, KT; Madathipat, U
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    Preclinical evaluation of hydrogel sealed fluropassivated indigenous vascular prosthesis
    (Indian Journal of Medical Research, 2018-03) Unnikrishnan, M; Umashankar, PR; Viswanathan, S; Savlania, A; Joseph, R; Muraleedharan, CV; Agrawal, V; Shenoy, SJ; Krishnan, LK; Mohanan, PV; Sabareeswaran, A
    Background & objectives: Polyethylene terephthalate (PET) graft, designed and developed at our institute for vascular reconstruction, is porous to promote optimal incorporation and neointima formation, requiring pre-clotting or biomodification by sealing the pores before implantation. The objective of this study was to characterize, test and perform preclinical evaluation of hydrogel (alginate dialdehyde cross-linked gelatin) sealed fluoropassivated PET vascular prosthesis in pig model, so as to avoid pre-clotting, for its safety and efficacy before employing the indigenous and less expensive graft for clinical use. Methods: Hydrogel sealed, fluoropassivated PET vascular prosthesis were tested for haemocompatibility and toxicity followed by small animal toxicology tests and in vivo experiments in pigs receiving implantation at thoracic aorta. All 33 animals received test as well as control grafts with a plan for phased explantation at 2, 12 and 26 weeks. All animals underwent completion angiogram at the end of procedure as well as before graft explantation. Results: Haemocompatibility tests for haemolysis and toxicity tests showed no adverse events in tested mice and rabbits. Completion angiogram showed intact anastamosis and patent graft in each animal in post-operative period and at explantation. Gross and histopathological examination showed wellencapsulated grafts, clean glistening neointima and no evidence of thrombus in both test and control grafts. Interpretation & conclusions: Hydrogel sealed, fluoropassivated PET vascular prosthesis was found non-toxic, haemocompatible and remained patent in in vivo studies at planned intervals.
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    Resection and reimplantation of a critically stenosed and 360 degrees coiled internal carotid artery
    (EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2015) Viswanathan, S; Parameshwarappa, SK; Mandjiny, N; Unnikrishnan, M