Publications by authors named "Bijulal Sasidharan"

Background: Research on pediatric restrictive cardiomyopathy (RCM), especially from the developing world, is limited. The study aimed to describe the clinical features and outcomes of childhood RCM and the predictors of outcome.

Methods: The study included all children with RCM who were < 18 years old.

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Surgical aortopulmonary shunting (SAPS) and ductal stenting (DS) are the main palliations in infants with cyanotic congenital heart diseases (CHD). We aimed to study the safety and efficacy of DS and to compare it with SAPS as a palliative procedure in infants with CHD and duct-dependent pulmonary circulation. Retrospective institutional clinical data review of consecutive infants aged < 3 months who underwent DS or SAPS over 5 years.

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The aorto-left ventricular tunnel is an extracardiac communication that has a specific morphological feature. It is important to differentiate this entity from other diagnoses because the treatment options differ significantly and better outcomes are obtained with this entity.

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Background: Several randomized trials have shown the effectiveness of drug-eluting stents (DES) over bare metal stents (BMS) in terms of repeat revascularization at 1 year; however long term data in this context is conflicting.

Aim: To assess the long term clinical outcomes after coronary artery stenting with drug-eluting stents and bare metal stents.

Methods: This is a retrospective cohort study, including 100 consecutive patients with Coronary Artery Disease who underwent successful percutaneous intervention (PCI) with implantation of DES and contemporary 100 patients who underwent PCI with implantation of BMS in the years 2005 and 2006 at our center.

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Article Synopsis
  • - The study compares the effectiveness of 3D transesophageal echocardiography (TEE) versus the more commonly used 2D TEE for planning device closures of atrial septal defects (ASD) in patients.
  • - Conducted over one year with 30 mostly female patients averaging 40.5 years old, both 2D and 3D TEE were used to assess defect characteristics, revealing a strong agreement between the two methods for measuring ASD diameters.
  • - Findings indicate that sizing the device based on 3D TEE parameters is as accurate as using 2D TEE, and an equation for predicting device size based on 3D metrics was developed, showing a high correlation
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Article Synopsis
  • Dilated cardiomyopathy (DCM) is a leading cause of heart failure in children, but research on pediatric cases is limited; this study aimed to evaluate the clinical profiles and outcomes of DCM in kids.
  • Out of 233 identified cases of pediatric cardiomyopathy, 119 were diagnosed with DCM, with common presentations including dyspnea and heart failure; many patients were treated with various heart medications.
  • Over a follow-up period, 45% of patients who were tracked died, 36% recovered, and infant onset was notably linked to higher mortality and arrhythmias; the 5-year survival rate data highlighted significant outcomes related to DCM.
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Coronary involvement in Kawasaki disease is not uncommon; however, giant coronary aneurysm exceeding 50 mm is extremely rare. In this article, we presented a case of giant coronary aneurysm involving right coronary artery with associated asymptomatic myocardial ischemia as evident by multimodality imaging.

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Total cavopulmonary connection, commonly referred to as the Fontan procedure, is the established destination therapy for univentricular hearts. While the procedure permits a longer survival of these patients, this circulation involves several compromises from normal human circulation and poses several challenges with increasing age after surgery. We present an instance of acute ST-elevation myocardial infarction with Guillain-Barre syndrome in an adult after Fontan palliation and discuss the challenges in management.

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Introduction: Although much research has been done on adult hypertrophic cardiomyopathy, data on pediatric hypertrophic cardiomyopathy is still limited.

Methods And Results: The study enrolled all patients with cardiomyopathy who presented to us between 1990 to 2020 and were younger than 18 yrs. During the thirty-year study period, we identified 233 cases of pediatric cardiomyopathy.

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Saphenous vein graft (SVG) aneurysm after coronary artery bypass grafting (CABG) is a rare complication. A fistula between an SVG aneurysm and a cardiac chamber is even rarer. Herein, we report a middle-aged man who underwent CABG with five grafts 13 years prior presenting with multiple aneurysms in the venous graft with a fistula between the aneurysm and the right atrium.

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Background: Patients with STEMI are postulated to have different culprit lesion morphology compared to NSTEMI. The use of OCT in ACS can help delineate lesion morphology. The aim of this systematic review was to analyze the available data on culprit plaque morphology in ACS patients.

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Background: Balloon-expandable pulmonary valves are usually not suitable for dilated native outflow tracts.

Methods: Indian Venus P-valve registry was retrospectively analyzed for efficacy, complications, and midterm outcomes. Straight valve was used in prestented conduits in patients with right ventricular pressure above two-thirds systemic pressure and/or right ventricular dysfunction.

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Development of pulmonary AV fistula (PAVF) after bidirectional glenn shunt (BDG) results in significant cyanosis, impaired exercise performance, and increased morbidity and mortality. We attempted to detect and quantify PAVF in post-BDG patients by saline contrast transesophageal echocardiography (TEE) and compare with pulmonary angiography and pulmonary vein oximetry. This was a prospective study done between 2017 and 2018.

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The double-barreled aorta connecting the ascending aorta and descending aorta caudal to the normal fourth aortic arch has fascinated the interests of cardiac morphologists for over a century. This condition is commonly associated with coarctation. While the controversies surrounding the embryology of the double-barreled aorta have settled down, we present a case-based illustration of the technical aspects of coarctation stenting peculiar to this condition.

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Background: The study examined the influence of significant tricuspid regurgitation (TR) on the immediate, early and mid-term outcomes of patients with severe mitral stenosis (MS) undergoing balloon mitral valvotomy (BMV).

Methods: Among the 818 consecutive patients who underwent elective BMV in this institute from 1997 to 2003, 114 had significant TR. After propensity score-matched analysis, the data of 93 patients with significant TR were compared with the data of 93 patients who had no significant TR at the baseline.

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Objective: Stenting of coarctation of aorta with covered or uncovered stents is the accepted modality of treatment in older children and adults. The indications which mandate the use of covered stents are still unclear. We attempted to study the early and late outcomes after stenting of native and recurrent coarctation of aorta with uncovered and covered stents.

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Background: Blalock-Taussig shunt (BTS) continues to have a relatively high operative and short-term mortality, even in the current era. We report the use of drug-eluting stent in a child with acute shunt thrombosis, which has not been reported in the literature to date.

Case Presentation: A 7-month-old boy with double outlet right ventricle, severe pulmonary stenosis, and normally related great arteries underwent BTS placement for cyanotic spells.

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Background: In rheumatic mitral stenosis (MS), left atrial (LA) thrombus and LA spontaneous echo contrast (LA SEC) reflect hypercoagulability. The study focuses on whether D-dimer levels predict the existence of LA thrombus and SEC in patients with severe MS.

Methods: 95 consecutive patients with severe MS referred for transesophageal echocardiogram (TEE) between July 2011 and March 2012 to evaluate LA thrombus prior to balloon mitral valvotomy (BMV) were included in the study.

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Aim: The aim of the study was to compare the immediate and late clinical outcomes of balloon mitral valvotomy (BMV), based on the immediate post-BMV valve area and percentage gain in mitral valve area (MVA).

Methods: Clinical data of 818 consecutive patients who underwent BMV in our institute from 2000 to 2008 were analyzed retrospectively. They were categorized into three groups based on the postprocedural MVA and percentage gain in valve area-(1) 50% gain with final MVA <1.

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A 2-month-old baby with ventricular septal defect and pulmonary atresia was found to have coronary-to-pulmonary artery collaterals. Cardiac computed tomography confirmed the coronary collaterals and showed the absence of other systemic to pulmonary artery collaterals. Although these collaterals do not cause coronary ischemia, it is important to delineate them by accurate imaging to plan the appropriate surgical strategy.

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