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Biomedical subjects

S Shrivastava

Publications and source records attributed to S Shrivastava.

At least 235 records · Page 13Linked to original sources
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Late rhythm abnormalities after surgical repair of tetralogy of Fallot: noninvasive and invasive evaluation.

Twenty five patients aged 6 to 35 years (mean +/- SD: 14.2 +/- 7.1 years), surgically corrected for tetralogy of Fallot (TOF) more than one year ago, were assessed for rhythm abnormalities by resting electrocardiogram (ECG), twenty-four hours ambulatory ECG monitoring, signal averaged ECG and electrophysiological studies. An X-ray chest for assessing heart size, two dimensional and Doppler echocardiography for residual defects and radionuclide angiography for resting left ventricular ejection fraction were also done. Eight out of 25 (32%) patients were found to have significant rhythm abnormalities. Ventricular arrhythmias were detected in four patients. In two, ventricular tachycardia was induced during electrophysiologic studies, being sustained in one. Multiform ventricular ectopics were observed in two other patients. All these patients were operated, after the age of 10 years, and three of them are presently more than 20 years old. Cardiomegaly was present in the chest X-ray in three patients, and significant residual pulmonary stenosis was seen in one patient. Left ventricular ejection fraction was reduced in two, while signal averaged ECG was positive in one of the three cases subjected to this investigation. Supraventricular tachycardia (SVT) was observed in three patients. This was diagnosed by ambulatory ECG monitoring in all but in addition, was also inducible in one patient on electrophysiologic testing. There was no correlation of the occurrence of SVT with age or age at correction for TOF. None of these patients had any residual defect, cardiomegaly or subnormal left ventricular ejection fraction. Transient complete heart block requiring temporary pacing was documented in one patient with a large residual ventricular septal defect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Congenital left ventricular inflow obstructions--an echocardiographic study.

Thirty nine consecutive cases of congenital left ventricular inflow obstructions (LVIO) diagnosed by two dimensional and Doppler echocardiography are described. The commonest referral diagnosis was severe pulmonary arterial hypertension. Confirmation by cardiac catheterisation and/or surgery was available in twenty one of these cases. The ages ranged from one month to 15 years (mean 3.8 +/- 4.5 years) and 28 were males. Four types of LVIO were defined: i) Congenital mitral stenosis (22 cases). Ventricular septal defect was the commonest association. ii) Cor-triatriatum (7 cases) Out of three patients operated, in one it was found to be a supravalvular mitral ring and not cor-triatriatum as earlier thought on echocardiography. iii) Pulmonary venous obstruction (8 cases). Atrial septal defect and ventricular septal defect were the common associations. iv) Supravalvular mitral ring (2 cases). Double outlet right ventricle and a large ventricular septal defect were associated with one case each. In our experience, two dimensional and Doppler echocardiography is a very useful and reliable investigation for defining the various types of congenital left ventricular inflow obstructions and their hemodynamic significance.

Adolescent↗
PubMedDate not supplied

Pulmonary arterial hypertension in patients with secundum atrial septal defects.

BACKGROUND: Experience in Vellore suggests that pulmonary arterial hypertension develops at an earlier age in Indian patients with secundum atrial defects than it does in westerners. We examined the haemodynamic data on patients with secundum atrial defects to determine whether this was also true in Delhi. METHODS: We analysed the data on 461 patients with secundum atrial defects, grouping them according to their pulmonary (Qp) and systemic (Qs) flow rates as well as the ratio of pulmonary to systemic systolic pressure (Pap/Sap) into 4 groups: [table: see text] RESULTS: There were 8 (2%) patients in group 1, 282 (61%) in group 2, 124 (27%) in group 3, 28 (6%) in group 4a and 19 (4%) in group 4b. Of the 19 patients in group 4b, 6 (1%) were below 20 years of age and 13 (3%) above 20 years. CONCLUSION: Our findings indicate that obstructive pulmonary arterial hypertension does not develop early in patients in Delhi.

Adolescent↗
PubMedDate not supplied

Transcatheter embolization of a coronary artery fistula.

A coronary artery fistula from left anterior descending coronary artery to right ventricle was successfully occluded by transcatheter embolization using steel coils. Transcatheter embolization seems to be the treatment of choice for coronary artery fistulas.

Cardiac Catheterization↗
PubMedDate not supplied

Effect of atrial septal defect created during balloon mitral valvuloplasty on calculation of cardiac output and mitral valve area.

We studied the effect of atrial septal defect (ASD), produced during transseptal puncture, on estimation of cardiac output (CO) and mitral valve area (MVA), after successful balloon mitral valvuloplasty (BMV) using the Inoue balloon in 20 patients. Oximetry run, pressure gradients, thermodilution CO and MVA were measured initially while temporarily occluding the ASD by partially inflating the Inoue balloon catheter. Measurements were repeated after withdrawing the balloon catheter into the right atrium. Post-BMV cardiac output and MVA were similar in both the situations (4.52 +/- 1.37 L/min vs 4.50 +/- 1.19 L/min; 1.89 +/- 0.4 cm2 vs 1.93 +/- 0.38 cm2 respectively, p = ns). Only 2 patients showed a step up at atrial level on oximetry (9% and 16% respectively) but did not have significantly different CO or MVA, both with ASD occluded or otherwise. We conclude that the magnitude of ASD created during BMV by Inoue balloon technique is small and does not significantly affect the estimation of CO or MVA if the septal puncture is done in the fossa ovalis area.

Adolescent↗