Tharumenthiran Ramanathan

• MBBS, PhD, FRACS
• Cardiothoracic Surgeon at Auckland City Hospital

Background Rheumatic heart disease remains one of the leading causes of heart valve disease worldwide despite being a preventable condition. Mitral valve repair is superior to replacement in severe degenerative mitral valve disease, however its role in rheumatic valve disease remains controversial. This meta-analysis compared mitral valve repair an...

Background: Transcatheter aortic valve implantation (TAVI) is an alternative and effective contemporary intervention to surgical aortic valve replacement (SAVR) for patients with severe aortic valve disease at increased surgical risk. Guidelines recommend a multidisciplinary "Heart Team" (MHT) review of patients considered for a TAVI procedure, bu...

Background: As the indications for transcatheter aortic valve implantation (TAVI) have expanded, so to have the demands on interventionists to allow as many patients to access this technology as possible. Methods: We retrospectively reviewed our TAVI database for patients who had received a 29mm SAPIEN 3 valve despite having an annular area grea...

Background The increasing prevalence of degenerative and functional mitral valve disease as the population ages alongside introduction of percutaneous mitral valve interventions mandates revision of outcomes of mitral valve surgery (MVS) in elderly and high risk patients. We compared the characteristics and outcomes of octogenarians and septuagenar...

Background: Risk stratification for mitral valve repair or replacement (MVR) is important in the decision-making for treating several mitral valve disease but is rarely studied. We compared the prognostic utility of EuroSCORE, EuroSCORE II, and Society of Thoracic Surgeons (STS) Score for MVR. Methods: The three scores were retrospectively calcu...

Background: Nearly half of the patients undergoing coronary artery bypass grafting (CABG) have diabetes. There is mixed data as to whether preoperative (haemoglobin A1c{HbA1c}) and/or perioperative diabetes control is associated with mortality and morbidity after CABG. We reviewed the characteristics and outcomes of diabetic patients undergoing CA...

Background: With the introduction of transcatheter aortic valve implantation (TAVI), there is increasing interest in evaluating outcomes of aortic valve replacement (AVR) with or without (+/-) concurrent coronary artery bypass grafting (CABG) particularly in high-risk patients. We reviewed the characteristics and outcomes of octogenarians undergoi...

Background: The Universal Definition for type 5 myocardial infarction (MI) applies to coronary artery bypass grafting (CABG), while MIs for other cardiac surgery are not specifically defined. We assessed whether elevated high-sensitivity troponin (hs-TnT), with electrocardiogram (ECG) changes and/or new wall motion abnormalities on echocardiography...

Background: Aortic valve replacement (AVR) and/or coronary artery bypass grafting (CABG) make up the majority of cardiac surgery with increasing demand as the population ages. Accuracy of risk stratification is important, in predicting adverse outcomes and selecting modality of intervention, but has been rarely studied for the combined AVR+CABG op...

Aims: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in high-risk patients. We report the initial TAVI experience at Auckland City Hospital. Methods: The records of patients undergoing TAVI between 2011 and 2015 at Auckland City Hospital were reviewed. We report the procedural success...

Background: Since troponins have become widely available, the roles of other less specific biomarkers for myocardial necrosis following coronary artery bypass grafting (CABG) have been seldom studied. Aspartate aminotransferase (AST) may not only be released from the heart but also from the liver or skeletal muscle. We assessed whether post-operati...

Atrial fibrillation (AF) is the commonest cardiac arrhythmia, becoming increasingly prevalent as the population ages. There is conflicting information around whether AF is associated with adverse outcomes after aortic valve replacement (AVR) from the few studies that have investigated this. We compared the characteristics and outcomes of patients u...

Obesity has significant adverse effects on cardiovascular health. Conflicting results have been reported regarding relationships between body mass index (BMI) and outcomes after coronary artery bypass grafting (CABG). We compared outcomes of CABG patients by BMI categories. Isolated CABG performed between July 2010-June 2012 at Auckland City Hospit...

Criteria for diagnosing myocardial infarction (MI) after coronary artery bypass grafting (CABG) are controversial. Uncertainties remain around the optimal threshold for biomarker elevation and the need for associated criteria. There are no studies of high-sensitivity troponin (hs-TnT) after CABG. We assessed whether using hs-TnT to define MI after...

Trans-catheter aortic valve implantation (TAVI) became available at Auckland City Hospital in 2011 for patients with severe aortic stenosis in whom surgical aortic valve replacement (AVR) was deemed at high risk. We assessed whether introduction of TAVI affected the characteristics and outcomes of octogenarians undergoing AVR. Isolated AVR performe...

Disparities for Maori exist in New Zealand for cardiovascular risk factors, events and access to revascularisation. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) between Maori and Europeans in New Zealand. Patients undergoing isolated CABG at Auckland City Hospital from July 2010-June 2012 were retrospectively a...

While men have higher rates of cardiovascular disease, several studies report women having higher mortality after cardiac surgery, reasons for which are unclear. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) by sex. All patients undergoing isolated CABG during July 2010-June 2012 were grouped by sex for retrospe...

Purpose: EuroSCORE had been the most widely used risk model for predicting outcomes after cardiac surgery for over a decade, but recent studies have found the score to over-estimate operative mortality. The revised EuroSCORE II and AusSCORE, based on an Australasian population, were recently developed. We compared the prognostic utility of EuroSCOR...

Purpose: Criteria for diagnosing myocardial infarction (MI) following coronary artery bypass grafting (CABG) are controversial. Uncertainties remain around the optimal threshold for biomarker elevation. There are no studies of high-sensitivity troponin (hs-Tn) assays after CABG. We assessed whether using hs-TnT to define MI was related to 30-day an...

Bronchopulmonary sequestration is a rare congenital pulmonary malformation for which surgical resection is recommended, and several reports have described successful resection by video-assisted thoracoscopic surgery. Coexistence of sequestration with lung malignancy is extremely rare. We report the first case of thoracoscopic resection of synchrono...