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Biomedical subjects

S Krishnaswamy

Publications and source records attributed to S Krishnaswamy.

99 records · Page 6Linked to original sources
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Surgical management of coarctation of aorta.

Between 1961 and 1988, 68 patients underwent operation for coarctation of the aorta. The average age of presentation of these subjects was higher than in other series. 7.1 percent were asymptomatic, a finding which is not seen in reports from the west. Operative procedures included resection and end to end anastomosis, resection and graft interposition, bypass grafting, patch aortoplasty and subclavian flap aortoplasty. However, the technique of patch aortoplasty, routinely performed in the last 24 years of this series seemed by far the most satisfactory procedure. Subclavian flap aortoplasty was carried out in a selected group of younger children. Associated cardiac anomalies influenced the results adversely. The overall operative mortality was 5.8 percent. Hypertension did not regress in 11.7 per cent of patients inspite of a successful operation as judged by the return of peripheral pulses in the lower limbs. Re-coarctation was not seen in this series. The overall results of operation for coarctation of the aorta have been very satisfactory and comparable with those in other published series.

Adolescent↗
PubMedDate not supplied

Aortic valve replacement in India. Early and long term results.

Experience with 261 subjects undergoing aortic valve replacement is presented. The mean age of our patients (29.6 years) is much less an compared to reports from the West. History of rheumatic fever was obtained in 53%. Aortic regurgitation was documented in 72.7% of our subjects whilst the remainder had calcific aortic stenosis. The left ventricular and diastolic pressure was elevated in 24% and the systemic index was less than 3 l/min/m2 in 71%. Associated mitral stenosis was present in 31 subjects (11.8%) who had concomitant open mitral valvotomy. The Starr-Edwards ball valve model 1260 was utilised in the great majority (76.6%). The overall hospital mortality was 9.9% which had decreased to 4.5% during the last five year period. Poor myocardial protection leading to low cardiac output occurring in class IV subjects was the cause of death in most instances. All survivors were followed up for periods ranging from 1 to 12 years (mean 4.2). Thrombo-embolic phenomenon occurred in 1.6 per 100 patient years and the incidence of paravalvar leak has been extremely low (0.4%). This is in striking contrast with reports from other authors. Actuarial analysis at the end of 5 years and 10 years indicates overall probability of survival of 92.9% and 92.2% respectively.

Adolescent↗
PubMedDate not supplied

Aortic valve replacement with concomitant open mitral valvotomy--early results and long term followup in 72 consecutive patients.

Experience with 72 consecutive subjects, who underwent aortic valve replacement with open mitral valvotomy is presented. Mean age was 30 years and history of rheumatic fever was forthcoming in 80%. 91.7% patients had aortic regurgitation--with or without aortic stenosis. 45% patients had pulmonary hypertension. Starr Edwards (51.4% and Bjork Shiley valves (45.8%) were commonly used. There were no early deaths. All patients were followed up for 1 to 19 years (mean = 9 years). There were 4 (5.5%) late deaths. 4.1% patients developed mild restenosis of the mitral valve over a mean period of 8 years and 1.04% developed mitral regurgitation mandating mitral valve replacement. A notable feature of this series is the low incidence of thromboembolism-free lives at upto 10 years followup despite receiving only aspirin in place of coumarin anticoagulation. We believe aortic valve replacement and open mitral valvotomy is a worthy alternative to double valve replacement in view of its zero hospital mortality, low late mortality, low incidence of restenosis, low thromboembolic episodes and the avoidance of coumarin anticoagulation.

Adolescent↗