Publications (2)0 Total impact
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ABSTRACT: IntroductionDouble chambered ventricle is a rare congenital cardiac anomaly, where the ventricular chamber is wholly or partially partitioned usually by abnormal muscular ridges. Double chambered right ventricle (DCRV) is more common than double chambered left ventricle (DCLV). MethodsA retrospective observational morphological study of 31 autopsied hearts during a 16-year period highlighted the varied clinical presentations of this pathology and the associated per-operative problems. ResultsDCRV was found to exist not only with simple cardiac pathologies such as ventricular septal defect and tetralogy of Fallot, but also more complex pathologies such as transposition of great arteries, double outlet right ventricle, left atrial isomerism, and Ebsteins anomaly of tricuspid valve. Double chambered left ventricle in our series was an associated asymptomatic anomaly. ConclusionsClosure of the ventricular septal defect may result in isolated DCRV causing proximal right ventricular (RV) hypertension. Postoperative RV dysfunction may compound the ill effects of missed DCRV, RV hypertension and pulmonary hypertension, if any. Double chambered left ventricle may present as an associated asymptomatic anomaly.Indian Journal of Thoracic and Cardiovascular Surgery 04/2012; 23(2):135-140.
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ABSTRACT: ObjectiveThe degree of Left Ventricular Mass Index (LVMI) regression following aortic valve replacement correlates with long-term survival. This study aims to assess the extent of LVMI regression at 3 months following aortic valve replacement (AVR) with different types and sizes of mechanical valves in rheumatic aortic valve disease. MethodsThe LVMI regression was studied in 34 consecutive patients, undergoing elective AVR for rheumatic aortic stenosis and/or regurgitation. They were grouped in A and B, matched in age, body surface area and pre-operative LVMI, receiving respectively a tilting disc and a bileaflet mechanical valve. The LVMI was calculated by M-mode echocardiography using the Devereux' formula pre-operatively and three months post-operatively. The trend of LVMI reduction was compared between the two groups and amongst the patients with stenotic, regurgitant and mixed aortic valve, pathologies; and receiving different sizes of valves. ResultsThe mean preoperative LVMI was 199g±79.5 g/m2. At three months post aortic valve replacement, the mean LVMI was 130g±49.0 g/m2. There was a significant reduction of LVMI post-operatively (p=0.001) at three months follow-up. The extent of LVMI regression following surgery amongst the groups A and B did not vary significantly (p=0.92). The extent of LVMI regression did not vary significantly in patients with different aortic valve pathology nor with different sizes of the valves implanted. ConclusionsThere is a significant early LVMI regression following aortic valve replacement in rheumatic aortic valve disease. The type and the size of the mechanical prosthesis or the rheumatic pathology do not appear to influence this regression.Indian Journal of Thoracic and Cardiovascular Surgery 04/2012; 22(2):121-125.