Baiju Sasi Dharan

Amrita Institute of Medical Sciences, Fort Cochin, Kerala, India

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Publications (7)3.74 Total impact

  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2006; 22(1):39-39.
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    ABSTRACT: Anomalous origin of the left coronary artery from the right pulmonary artery is a very rare congenital anomaly, and its occurrence with coarctation of the aorta has been reported in very few patients. We report a neonate where the coronary anomaly was missed preoperatively and diagnosed after repair of the coarctation. The patient thereafter underwent ligation of the left anomalous coronary artery and had an uneventful convalescence.
    The Annals of thoracic surgery 08/2004; 78(1):324-6. · 3.74 Impact Factor
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2004; 20(1):24-25.
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2004; 20(1).
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2004; 20(1):19-20.
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    ABSTRACT: AimTo study the results of repair of Total Anomalous Pulmonary Venous Connection (TAPVC) in neonates Materials and MethodsRetrospective study of 27 neonates operated for TAPVC between January 2001 and October 2003. 27 neonates underwent TAPVC repair during the 2-year period. 21 were males and 6 were females. ResultsTotal hospital stay ranged from 10 days to 75 days. 9 supracardiac, 13 infracardiac, 3 cardiac and 2 mixed type comprised the group. Obstruction was seen in 24 patients. All the patients had severe pulmonary artery hypertension. Vertical vein was ligated in almost all cases either at the time of surgery or during the closure of sternum. Delayed sternum was closed in all cases but 7. Of 3 deaths, one died after permanent pacemaker implantation (about 1 month after the initial surgery of repair of cardiac TAPVC), one died due to pre-operative vascular access related accident and a third died due to post-operative low cardiac output. All survivors were thriving well at last follow-up. ConclusionRepair of TAPVC in the neonatal age has been found to be rewarding with significant improvement in the well being of the child. Judicious use of pulmonary vasodilators like nitric oxide, Sildenafil and phenoxybenzamine and delayed sternal closure has improved the results in this study group.
    Indian Journal of Thoracic and Cardiovascular Surgery 20(4):155-158.
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    ABSTRACT: The ideal age for bidirectional Glenn shunt (BDGS) as the first stage of staged Fontan is still not clear. Because of the concerns regarding relatively high pulmonary vascular resistance during infancy, many centres would bridge through a systemic to pulmonary artery shunt in this age group. Patients and MethodsWe did a retrospective analysis of 28 infants who had undergone bidirectional Glenn shunt at our institute from February 200. ResultsThe mean age was 5 months (2.5–11) and the mean weight was 6.5 Kg (3.4–8.7). Boys dominated the group (25∶3). 7 infants had previous procedures. In 3 patients, BDGS was done as a salvage procedure. Formal Cardiopulmonary bypass (CPB) was used in all but 4 patients, in whom a right heart bypass was used. Superior Vena Cava (SVC) or innominate vein was cannulated in 12 patients and the rest were managed with temporary occlusion of SVC under deep hypothermic low flow bypass. 9 infants had bilateral BDGS. The main pulmonary artery was interrupted in 12 and atrial septectomy was done in 10 patients. Additional procedures with BDGS included Patent Ductus Arterious (PDA) interruption, Blalock Taussig (BT) shunt interruption, Left pulmonary arterioplasty, Stansel procedure and redo TAPVC repair. The mean SVC pressure post operatively was 14 (10–24) and only 2 patients needed pulmonary vasodilators in the post-oprative period. There is only one mortality in this series and the duration of chest tube drainage and Intensive Care Unit (ICU) stay is comparable with the older age group. ConclusionBDGS can be performed safely in infants more than 2 months of age electively or as a salvage procedure. It helps to avoid one step in the form of aortopulmonary shunt and hence the ventricular volume overload associated with it. Further studies are required to establish the growth potential of pulmonary arteries following an early BDGS.
    Indian Journal of Thoracic and Cardiovascular Surgery 20(4):159-163.