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Biomedical subjects

S Muralidharan

Publications and source records attributed to S Muralidharan.

69 records · Page 4Linked to original sources
PubMedDate not supplied

Intracardiac repair of tetralogy of Fallot in adults.

This study demonstrates that total surgical correction in tetralogy of Fallot is a gratifying procedure even with advancing age especially when one reckons that a great majority of these patients showed pronounced disability at the time of surgery without the benefit of previous palliative procedures. However, there are technical difficulties in accomplishing repair in the fibrotic hearts of older patents. The early mortality and long term benefits in this age group closely parallel those in our over all experience with surgery for this anomaly. There was a 12.5% early and 10% late mortality in this series. Surviving patients have been followed up for a period ranging from 1 to 10 years (mean 18 months) and are found to be leading normal active lives.

Adolescent↗
PubMedDate not supplied

Total anomalous pulmonary venous return in children and adults. Results of corrective surgery.

The operative technique and the early and long term results are described in twenty consecutive patients who have undergone corrective surgery for total anomalous pulmonary venous return over a 12 year period from 1967 to 1979. There was a 15 per cent early mortality which occurred only in children below the age of four. There have been no late deaths. All survivors are leading normal gainful lives. Nine of seventeen have been recatheterised. The abnormality when encountered in children and adults carries a more favourable prognosis than when encountered during infancy.

Adolescent↗
PubMedDate not supplied

Short phase efficacy of autologous peritoneum as a pericardial substitute.

The risks associated with resternotomy are largely related to loss of pericardial integrity. No satisfactory substitute for pericardium has been identified. The structural similarity between pericardium and peritoneum prompted an assessment of the latter as a biologic substitute. Two peritoneal patches were harvested from four juvenile swine, which then underwent left thoracotomies. In each pig, two pericardial defects were created and repaired with fresh and glutaraldehyde treated autologous peritoneal patches. Three weeks post operatively, the chest and abdomen were re-explored and the patches evaluated. In all cases, extrapericardial adhesions were insignificant. On gross examination of the intrapericardial surfaces, the fresh patches appeared smooth and glistening, with neither degenerative changes nor adherence to the epicardium. The treated patches were easily separated from the epicardium in two cases, but the other two patches were moderately to severely adherent. Histologic examination demonstrated well preserved morphology in all patches. C proline uptake and autoradiography revealed preserved fibroblast viability in the fresh patches. Intra abdominally, in all cases, there was complete reperitonealization without adhesion formation. In conclusion, fresh autologous peritoneum performed well as a pericardial substitute after heart surgery.

Animals↗
PubMedDate not supplied

A new biologic membrane in cardiovascular surgery.

Reconstruction techniques for major vessels and intracardiac defect repair use synthetic grafts or autogenic pericardium. Here, autologous abdominal parietal peritoneum with the overlying posterior rectus sheath as a biologic membrane are evaluated. Twelve adult canines were used. Via a midline subumbilical incision, the parietal peritoneum and overlying posterior rectus sheath were harvested. In the first group of six, the membrane was used to repair the right ventricular infundibulum and perform pulmonary artery annuloplasty. In the second group of six, under cardiopulmonary bypass and moderate hypothermia, the right atrium was opened and a secundum type defect was created. Autopsies performed 90 days after surgery revealed mild intrapericardial adhesions and moderate pericardial reaction over the cardiotomy incisions. The right ventricular outflow tract patch was nonaneurysmal. The interatrial patch was intact without thrombi. Histologic examination revealed intact membrane morphology, fibroblasts, smooth muscle cells, and endothelialization. Proline C14 uptake and autoradiography detected cellular viability of implanted membranes. These findings suggest that the peritoneum with overlying sheath repaired vascular and intracardiac defects and substituted for pericardium. Future studies are needed before clinical use.

Animals↗