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Biomedical subjects

I P Sukumar

Publications and source records attributed to I P Sukumar.

At least 37 records · Page 2Linked to original sources
PubMed1981

The adult ductus: review of surgical experience with 131 patients.

Results in patients over 14 years of age who have undergone surgical closure of a patent ductus arteriosus during the period 1967 through 1979 have been reviewed. There were 131 subjects (average age 22 years) with a slight male predominance, which is at variance with other reports. Sixty-two subjects underwent hemodynamic evaluation and of these, 30 had pulmonary artery pressures ranging from 50 to 150 mm Hg. Division and suture of the ductus with aortic cross-clamping under normothermic conditions was performed in 61 subjects. This approach was particularly indicated in cases in which the ductus was unusually short in relation to its diameter as well as in many with atheromatous changes at the aortic end. In 65 subjects, the conventional division and suture with ductus clamps was employed. Total cardiopulmonary bypass with transaortic patch closure of the ductus was carried out in three instances. There were five early deaths which were principally associated with severe pulmonary hypertension. During a follow-up period extending from 1 to 11 years, three subjects died, but the remainder are well and active. Recatheterization data in nine patients with severe pulmonary hypertension showed gratifying results.

Adolescent↗
PubMed1980

Experience with the surgical treatment of coarctation of the aorta in India.

Between 1961 and 1977, 51 patients underwent operations for coarctation of the aorta. The average age of presentation of these cases was higher than in other series. Only three were asymptomatic, a finding which is not seen in reports from the West. Operative procedures included resection and graft interposition, resection and end-to-end anastomosis, and bypass grafting. However, the technique of patch angioplasty, routinely performed in the last three years of this review, seemed by far the most satisfactory procedure. The overall operative mortality was 9.8%. Hypertension did not regress in some cases in spite of a successful operation. Recoarctation was not seen in this series. Associated defects influenced results adversely. The overall results of operation for coarctation of the aorta have been very satisfactory and comparable with those in other recorded series.

Abnormalities, Multiple↗
PubMed1979

Tetralogy of Fallot in adults. A report on 147 patients.

Presented here is the clinical and hemodynamic profile of 147 patients, above the age of 18 with tetralogy of Fallot. Cardiac catheterization and selective cineangiocardiography were performed in all. Infundibular pulmonary stenosis, a subaortic large infracristal ventricular septal defect, mitral-aortic fibrous continuity and equal pressures in both the ventricles and aorta were considered mandatory for the diagnosis of tetralogy of Fallot. Cardiac enlargement was seen in 25.8 per cent of the patients, and 15.6 per cent were in congestive cardiac failure; 9.5 per cent had systemic hypertension, and aortic regurgitation was present in 6.7 per cent. A reticular pattern in the lung fields due to bronchial collaterals was seen in 23.1 per cent. The incidence of right aortic arch (19.9 per cent), absent left pulmonary artery (2.8 per cent), absent right pulmonary artery (0.7 per cent) and dextrocardia (1.4 per cent) is brought out. The right atrial mean pressure was increased in 4.8 per cent and a prominent "a" wave greater than 10 mm Hg was present in 10.9 per cent. The right ventricular end-diastolic pressure was increased in 23.8 per cent and the left ventricular end-diastolic pressure in 25.9 per cent of the patients.

Adolescent↗
PubMed1978

Restenosis of the mitral valve: surgical considerations and results of operation.

Our experience over an eight-year period with 63 consecutive patients with mitral restenosis who underwent operation forms the basis for this report. Striking clinical disability was a notable finding. A majority of the patients were less than 30 years old. Embolic phenomena were rare. Closed transventricular valvotomy offers excellent low-risk palliation and good long-term results. Follow-up showed excellent or good results in 90.5% of the patients and poor results in 9.5%. Hemodynamic study of 6 patients demonstrated a pronounced decrease in the pulmonary artery pressure. Open valvotomy was performed in 6 subjects. The presence of intracardiac calcification together with mild mitral incompetence in 2 patients made valve replacement mandatory. The problem of restenosis of the mitral valve is complex, and only after further long-term results are available will the superiority of any one method be demonstrated.

Adolescent↗
PubMed1978

Severe pulmonary hypertension in advanced aortic valve disease.

Review of haemodynamic data of 151 cases with isolated aortic valve disease revealed severe pulmonary hypertension (pulmonary arterial systolic pressure of 60 mmHg or more) in 17 (11%). The left ventricular end-diastolic pressure was high in all but one case, suggesting that the severe pulmonary hypertension was a reflection of the late stages of aortic valve disease. The majority (64.7%) had a low cardiac index. Premature closure of the mitral valve was seen in 12 of the 17 patients. While the incidence of premature mitral closure was the same as in others with mild and moderate pulmonary hypertension, the average reversed ventriculoatrial gradient was higher in the latter groups.

Adolescent↗
PubMed1977

Left ventricular endomyocardial fibrosis in India.

Clinical, radiological, electrocardiographic, haemodynamic, and cineangiographic features of left ventricular endomyocardial fibrosis are described in 8 patients seen during the 10-year period 1965-1975. Exertional dyspnoea was the commonest presenting symptom. Mild to moderate cardiomegaly was often present. The apex beat was never forcible. A loud third heart sound over the apex and an apical early systolic murmur with late systolic decresendo were characteristic of this desease. Chest X-rays films showed left atrial enlargement and pulmonary venous congestion. A pronounced rise in left ventricular end-diastolic pressure, severe pulmonary hypertension, and low cardiac index were seen in 6. Ventriculography showed an irregular, poorly contracting left ventricle with areas of dyskinesis and large end-systolic volume. Mitral regurgitation, when present, was not severe.

Adolescent↗