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A Sampath Kumar

Publications and source records attributed to A Sampath Kumar.

25 records · Page 2Linked to original sources
PubMedDate not supplied

Pathological aspects of explanted homograft mitral valve.

BACKGROUND: Homograft mitral valve replacement is an alternative therapeutic approach to prosthetic or bioprosthetic valve replacement. The present paper documents the pathological changes of explanted homograft mitral valve. METHODS: We examined six explanted homograft mitral valves, which were taken out 6 weeks to 60 months following valve replacement procedure. Gross examination of the specimens was done, and representative sections were evaluated using haematoxylin-eosin, Masson's trichrome, Verhoeff's van Gieson and von Kossa stains. RESULTS: On gross examination, the valves showed leaflet calcification and chordal rupture at the tip of the papillary muscles in three cases each. Microscopically, the valve leaflets appeared as aneucleated structures with loss of endocardial lining and lack of nuclear details. The collagenous skeleton was largely preserved. The papillary muscles underwent coagulative necrosis and lacked significant inflammatory infiltrate. One case had a few macrophages at the periphery of myonecrosis, while two cases revealed focal foreign body giant cell reaction. Foci of dystrophic calcification within the areas of myonecrosis were present in three cases. CONCLUSION: Homograft mitral valve undergoes degenerative changes in the recipient, some of which can be attributed to ischaemia.

Adolescent↗
PubMedDate not supplied

Non-myxomatous cardiac tumours: twenty-year experience.

Eighty-eight patients underwent surgery for various cardiac tumours from January 1978 to June 1998 at our Institute. Seventy-seven tumours were myxomas, 10 were non-myxomatous and one was secondary cardiac tumour. Case records of the patients with non-myxomatous primary cardiac tumours and one secondary tumour were reviewed. Six of these primary tumours were benign and four, malignant. Age of the patients ranged from 26 days to 47 years. Among patients (3 children, 8 adults) with non-myxomatous primary cardiac tumours, dyspnoea on exertion was the commonest symptom and was the cause of presentation in seven out of 11 patients. Of the eight adults, six were in New York Heart Association functional class II/III and two in class IV. Echocardiographic diagnosis was possible in all the patients. Complete excision of the tumour was possible in all benign and two of the four malignant tumours. Incomplete resection was done in the secondary tumour. Of the six benign tumours, three were rhabdomyomas and one each of fibroma, haemangioma and lipoma. The malignant tumours were one each of fibrosarcoma, angiosarcoma, unclassified sarcoma and malignant mesothelioma. The secondary tumour was a malignant thymoma. Follow-up ranged from 1 to 10 years (mean 7.2 years). Of the patients with benign tumours, four out of six are alive; one patient died on the first post-operative day and one lost to follow-up. Two of the four patients with malignant cardiac tumours died, one was lost to follow-up and one is alive two years after surgery. The patient with secondary malignant thymoma to the superior vena cava was lost to follow-up three months after an uneventful recovery from surgery.

Adult↗
PubMedDate not supplied

Pulmonary autograft mitral valve replacement: initial experience with the Ross II procedure.

BACKGROUND: The renewed interest in mitral valve replacement with a pulmonary autograft encouraged us to perform this procedure in selected patients. METHODS AND RESULTS: From August 2000 to February 2002, 10 patients between 30 and 52 years of age with calcific mitral valvular disease underwent the Ross II procedure. Patients were either in New York Heart Association functional class III (7/10) or IV (3/10). Transthoracic echocardiography was done in all the patients to confirm the diagnosis. A pulmonary autograft was used to replace the diseased mitral valve. Intraoperative transesophageal echocardiography confirmed normal functioning of the autograft. There were 2 early deaths. The 8 survivors are in New York Heart Association functional class I with excellent autograft and homograft function at a follow-up of 2-20 months (mean 9 months). CONCLUSIONS: This procedure is a viable option for mitral valve replacement in patients with calcific mitral valve disease. However, the procedure is technically demanding and requires a valve bank.

Adult↗