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Biomedical subjects

S Harikrishnan

Publications and source records attributed to S Harikrishnan.

At least 19 recordsLinked to original sources
PubMed2006

Accidental sizing of patent foramen ovale during atrial septal defect sizing for device.

A 21 year old lady with a 22 mm secundum atrial septal defect with adequate rims, and thin septum at the region of the fossa ovalis, but no additional atrial septal defect by transthoracic and transoesophageal echocardiogram was taken up for ASD sizing with a view to device closure. Initially, the ASD was sized to only 8 mm. However, the distal balloon was not fully opened out, and seemed to be conical with restricted opening. Inadvertent passage of sizing balloon through a patent foramen ovale (PFO) was immediately confirmed by transthoracic echocardiogram. The ASD was then recrossed and sized to 24 mm with normal opening out of the distal balloon. This was confirmed by transthoracic echocardiogram. A 28 mm ASD device was deployed across the ASD under transthoracic echocardiographic guidance with no residual flow.

Adult↗
PubMed2006

Percutaneous transmitral commissurotomy in juvenile mitral stenosis--comparison of long term results of Inoue balloon technique and metallic commissurotomy.

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.

Adolescent↗
PubMed2006

Percutaneous transvenous mitral commissurotomy using metallic commissurotome: long-term follow-up results.

BACKGROUND: We report the long-term follow-up results of percutaneous transvenous mitral commissurotomy (PTMC) using metallic commissurotome, which is proposed as an alternative to Inoue balloon use. METHODS: PTMC using a metallic commissurotome was performed in 248 patients (65 men) by the anterograde transseptal technique. Of the 248, 64 of the procedures were for mitral restenosis after previous valvotomy. RESULTS: The procedure was successful in 230 patients (92.7%). Following PTMC, the transmitral gradient decreased from 14.54 +/- 5.79 mmHg to 4.26 +/- 2.82 mmHg (p less than or equal to 0.001). The mitral valve area (MVA) increased from 0.85 +/- 0.12 cm2 to 1.95 +/- 0.31 cm2 (p less than or equal to 0.001). One patient died due to left ventricular perforation (mortality rate = 0.41%). Another patient who developed a left ventricular tear underwent repair of the tear along with open mitral valvotomy. Four patients developed significant mitral regurgitation (MR) from a tear of valve leaflets and had to undergo emergency mitral valve replacement. One patient had a transient ischemic attack and 5 patients developed moderate MR caused by excessive split of valve commissures. The mean follow up period was 3.34 +/- 0.66 years. Six patients were lost to follow up. Seven of the remaining 224 patients developed mitral restenosis. At follow up, the mean pressure gradient across the mitral valve assessed by echocardiography was 6.09 +/- 3.12 mmHg. The mean mitral valve area decreased to 1.67 +/- 0.34 cm2, but clinical improvement persisted in most of the patients. CONCLUSION: PTMC with metallic commissurotomy is safe and produced good results which were sustained at a follow-up period of more than 3 years.

Adult↗
PubMed2005

Self-blood letting in congestive cardiac failure.

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.

Adult↗
PubMed2005

Acute phase reactants predict mitral regurgitation following mitral valvuloplasty.

This report evaluated whether acute phase reactants can predict the development of mitral regurgitation following percutaneous mitral valvotomy. 58 patients who developed significant mitral regurgitation following valvotomy were retrospectively compared with 58 age, sex and procedure technique matched control patients, who had valvotomy without mitral regurgitation. ESR and total leucocyte count were significantly higher in the group who developed mitral regurgitation, than in the control group. Higher ESR and total leucocyte count may be indicative of ongoing low grade sub-clinical inflammatory process, which makes the valve tissue friable which can give way during balloon stretch and lead onto mitral regurgitation.

Acute-Phase Proteins↗
PubMed2005

Intracranial aneurysms, coronary aneurysms and descending aortic coarctation--unreported association.

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.

Abnormalities, Multiple↗
PubMed2004

Brugada syndrome.

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.

Adult↗
PubMed2003

Percutaneous balloon mitral valvotomy and coronary stenting in the same sitting.

Rheumatic heart disease (RHD) is still highly prevalent in developing countries like India, while the incidence of coronary artery disease (CAD) is on the rise. So the occurrence of a combination of RHD with CAD becomes more likely. We describe a patient with severe mitral stenosis and tight stenosis of the left anterior descending (LAD) coronary artery who underwent two percutaneous interventional procedures (balloon mitral valvotomy and coronary stenting) simultaneously. Specific problems associated with the combination of the two procedures are discussed.

Angioplasty, Balloon, Coronary↗