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Dive into the research topics where Roy Varghese is active.

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Featured researches published by Roy Varghese.


Pediatric Cardiology | 2006

Right ventricular diastolic function after repair of tetralogy of Fallot.

M.S. Sachdev; A. Bhagyavathy; Roy Varghese; Robert Coelho; Raghavannair Suresh Kumar

The objective of this study was quantitate diastolic dysfunction in the postoperative phase of tetralogy of Fallot (TOF) and to correlate it with the type of surgical procedure and clinical parameters. Fifty consecutive patients (mean age, 5.0 years; mean weight, 13.5 kg), operated for TOF during the period November 2004 to May 2005, were prospectively studied [infundibular resection, 23; infundibular resection and transannular patch (TAP), 19; right ventricle→pulmonary artery conduit, 8). Detailed echocardiography was done on postoperative days 3 and 9 with a focus on Doppler indices of right ventricular (RV) function, Antegrade late diastolic flow in the right ventricular outflow tract (RVOT) was taken as the marker of restrictive RV physiology. The previous parameters were correlated to the type of surgery and clinical indices of RV dysfunction. There was no mortality. Twenty-four patients showed restrictive RV physiology. This finding correlated with lower values of E/A ratio (0.98u2009±u20090.17 vs 1.33u2009±u20090.49, p < 0.002), tricuspid valve E-wave deceleration time (86.9u2009±u200921.7 vs 151.4u2009±u2009152 msec, p < 0.05), index of myocardial performance (0.15u2009±u20090.06 vs 0.26u2009±u20090.09, p < 0.001), isovolumic relaxation time (19.4u2009±u200917 vs 39±30 msec, p < 0.009), and a higher central venous pressure (15.1u2009±u20091.5 vs 12.7u2009±u20091.9, p < 0.001). Restrictive RV physiology correlated with prolonged intensive case unit (ICU) stay (5.1u2009±u20093.7 vs 2.8u2009±u20092 days, p < 0.015), longer duration of inotropic support (108.3u2009±u200956.2 vs 55.5u2009±u200928.3 hours, p < 0.02), and higher dosage of diuretics. RV diastolic dysfunction is demonstrable by Doppler echocardiography in the first week following surgery for TOF and tends to be worse with TAP. Restrictive physiology demonstrated by RVOT pulse Doppler predicts longer duration of inotropic support, prolonged ICU stay, and higher dosage of diuretics.


The Annals of Thoracic Surgery | 2001

A new repair for anomalous left coronary artery

Kona Samba Murthy; Shivaprakasha Krishnanaik; Smruti R Mohanty; Roy Varghese; Kotturathu Mammen Cherian

We report a new technique of left coronary artery implantation to the aorta with interposition of a tube created from the great arterial wall for anomalous left coronary artery from pulmonary artery. This technique was used in 3 patients, of which 2 patients survived. It achieves two coronary artery repair and avoids problems related to extensive mobilization of coronary artery for translocation. It is easily reproducible.


Congenital Heart Disease | 2011

Outcome of complex adult congenital heart surgery in the developing world.

Ganesh Kumar Gnanappa; Madhusudan Ganigara; Atul Prabhu; S.V.K. Varma; Uday Murmu; Roy Varghese; John Valliatu

BACKGROUNDnThere is scanty information on the outcome of adult congenital heart disease surgery from the developing world.nnnMETHODSnThis was a retrospective chart review of the surgical outcome of 153 adults with congenital heart disease over a 5-year period. Surgical atrial septal defect closure was considered simple while all other surgeries were considered complex.nnnRESULTSnu2002 There were 102 patients in the simple group and 51 in the complex group. Only three (2%) patients had prior operations. The complex group had longer bypass time and cross clamp time. Intensive care unit stay, ventilation time, and inotrope administration were longer. Major complications were more common and there were two deaths in the complex group. Age more than 30 years, cyanosis, and New York Heart Association class more than II were predictors of longer stay in the intensive care unit. Surgical repair of Tetralogy of Fallot in adults tended to have a longer ventilation time and intensive care unit stay with a mortality of 4%. At follow up, all patients were in New York Heart Association class I or II. Improvement of the functional class with negligible adverse events was noted in both groups.nnnCONCLUSIONSnu2002 A retrospective evaluation of 153 adults with congenital heart disease who underwent open heart surgery at a single center in India showed strikingly fewer reoperations compared with large European studies. There was a similar prevalence of complex lesions. Surgical mortality was low, and long-term functional outcome was gratifying.


Asian Cardiovascular and Thoracic Annals | 2011

Computed tomographic angiography in tetralogy of Fallot

Pankajkumar Ashok Kasar; Radhakrishnan Ravikumar; Roy Varghese; Monika Kotecha; Jesudian Vimala

Echocardiography is often inadequate for imaging tetralogy of Fallot, prompting cineangiography. This study prospectively evaluated multidetector computed tomographic angiography for preoperative evaluation of tetralogy of Fallot in 112 consecutive patients. Forty-eight had nonconfluent or hypoplastic pulmonary arteries (mean z-score, −2; range, −11.1–0.13) permitting only palliative or no surgery; 64 had adequate pulmonary artery anatomy (mean z-score, 0.59; range,−2.53–3.4) allowing total repair. The surgical data of 50 patients who underwent total correction were compared with transthoracic echocardiography and multidetector computed tomographic angiography findings. Multidetector computed tomographic angiography tended to reveal unsuspected collaterals and coronary abnormalities besides outlining the right ventricular outflow tract and pulmonary artery branches. The branch pulmonary artery diameter z-score was the most important determinant of surgical strategy, with the worst figures being associated with no surgical options or palliative surgery, and the best figures leading to corrective surgery. The mean radiation dose was 3.45u2009mSv. Multidetector computed tomographic angiography is a powerful supplement to echocardiography in the preoperative evaluation of tetralogy of Fallot.


Pediatric Cardiology | 2013

Isolated total anomalous systemic venous drainage in an adult: case report.

Vimalarani Devendran; Roy Varghese; Krishnaya Gudeboyana; Vimala Jessudian

Total anomalous systemic venous drainage is a rare form of congenital heart disease. All the systemic venous flow from the body (i.e., from the superior vena cava, inferior vena cava, and coronary sinus) drains abnormally into the left atrium. This condition requires the presence of a left-to-right shunt (atrial septal defect, patent ductus arteriosus, or ventricular septal defect) to allow the systemic venous return to reach the pulmonary circulation. This disorder may be associated with heterotaxy syndromes. This report describes a patient with unique total anomalous systemic venous drainage that was successfully corrected surgically.


Asian Cardiovascular and Thoracic Annals | 2013

Surgical outcome of congenital heart disease in Down’s syndrome

Praveen S Lal; Bhushan Chavan; Vimala Rani Devendran; Roy Varghese; Uday Murmu; Raghavannair Suresh Kumar

Background and objective: only a few studies have compared surgical outcomes in children with and without Down’s syndrome. The purpose of this study was to investigate the surgical outcome in children with Down’s syndrome and congenital heart disease and to compare it with that in age- and sex-matched non-Down controls. Patients and methods: the charts of 32 consecutive Down’s syndrome patients who underwent surgery for congenital heart disease in a single center from January 2006 to May 2010, were compared with the data of 32 age- and sex-matched non-Down controls, focusing on comparative echocardiographic details, surgical outcome, and intensive care unit data. The data were compared using the 2-group t test. The children were followed up for a median period of 48 months. Results: the most common cardiac lesion in the study group was ventricular septal defect (41%) followed by atrioventricular septal defect (28%). Ventilation and intensive care unit stay were significantly longer in Down’s syndrome children, with a trend towards more respiratory complications. At a median follow-up of 48 months, there were no cardiac events or mortality in the study group. Simple lesions were more common than atrioventricular septal defect in Down’s syndrome. Conclusion: children with Down’s syndrome can be operated on with negligible mortality and good functional outcome, but with a higher surgical morbidity.


Asian Cardiovascular and Thoracic Annals | 2006

Outcome of Single Ventricle and Total Anomalous Pulmonary Venous Connection

Manvinder S Sachdev; Pradyumna K Jena; Renu P Kurup; Roy Varghese; R. Suresh Kumar; Robert Coelho

Management of patients with single-ventricle physiology is significantly affected by anomalies of pulmonary venous return at all stages, whether primary palliation, bidirectional Glenn shunt, or completion of Fontan circulation. We treated 25 patients with pulmonary venous anomalies and single ventricle by staged palliation, from June 1996 to May 2005. Visceral heterotaxy with atrial isomerism was present in 19 of them. Primary palliation with a systemic-to-pulmonary artery shunt was undertaken in 15 patients. There were 5 early deaths, of which 4 were due to obstruction of pulmonary venous return. A bidirectional Glenn shunt was constructed in 17 patients including 10 who had it as a primary palliative procedure. There were 7 early deaths after the bidirectional Glenn procedure; only one was due to pulmonary venous obstruction. Five patients attained completion of the Fontan procedure. There was one early death after the Fontan operation. Anomalous pulmonary venous return can significantly complicate the management of patients with single ventricle, with an impact on survival in early infancy. Palliation with the aim of instituting extracardiac conduit Fontan circulation allows greater latitude and more streamlined management.


Heart Lung and Circulation | 2012

Visceral Heterotaxy in the Developing World

Deepak Kishinchand Changlani; Monika Kotecha; Trupti Dongre Changlani; Roy Varghese; Raghavannair Suresh Kumar

BACKGROUNDnThe challenge of visceral heterotaxy (VH) in the developing world has not been analysed in detail.nnnMETHODnRetrospective chart review of 69 consecutive patients over ten years assessed the clinical profile and surgical outcome of VH. Median age: 3 years; median weight: 15kg. Diagnosis was made by echocardiography supplemented with blood smear (Howell Jolly bodies), Multi-Detector Computed Tomography (MDCT) angiogram and/or surgical inspection.nnnRESULTSnIn right isomerism (RI) group (n=32), 12 patients did not undergo surgery, five had Blalock Taussig shunt, 14 had bidirectional Glenn and one had Fontan completion, with surgical mortality of 5%. In left isomerism (LI) group (n=31), 11 patients underwent two ventricle repair (35%) and 15 (48%) had single ventricle repair, with surgical mortality of 3.8%; five did not have surgery. On follow up (median period 1.5 years), 33% of un-operated patients and 25% of operated patients died, mortality being higher for RI patients. Late mortality was due to sepsis, heart failure or arrhythmia.nnnCONCLUSIONnVH can be diagnosed by imaging based criteria. VH tends to present late in the developing world with a significant percentage inoperable. LI had better surgical outcome and higher long term survival.


Asian Cardiovascular and Thoracic Annals | 2017

Pediatric heart transplant for unresectable primary cardiac tumor

Anjith Prakash Rajakumar; Sheriff Ejaz Ahmed; Roy Varghese; Sivakumar Kothandam; Udaya Charan Murmu; Rajan Sethuratnam

Surgery for primary cardiac tumors in children includes complete resection, partial resection, and cardiac transplantation. A pediatric heart transplant in this setting is associated with significantly higher mortality and poorer long-term outcome, and it is reserved for unresectable tumors. We recently performed an emergency pediatric heart transplant in a 7-year-old boy with an unresectable cardiac fibroma in the left ventricle.


Annals of Pediatric Cardiology | 2015

The pressures of surgicel(®) in cardiac surgery.

Niket Arora; Roy Varghese; Sreeja Pavithran; Sivakumar Kothandam

Surgicel® is bioabsorbable hemostatic mesh, frequently packed around oozing surgical bed. We report two morbidities due to it. Following transannular patch repair for Fallot′s tetralogy, Surgicel® was packed around distal main pulmonary artery. Echocardiography in the intensive care unit (ICU) showed right ventricular dysfunction due to extrinsic obstruction and complete occlusion of left pulmonary artery (LPA) flows. Another patient with arterial switch operation had postoperative fibrillatory cardiac arrest, needing resuscitation with internal cardiac massage. The arrest was triggered by coronary ischemia due to periaortic compression. Both instances were caused by hygroscopic nature of Surgicel®, which absorbed blood, swelled, and compressed the luminal tissues.

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Kumar S

Madras Medical Mission

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Morris M

Madras Medical Mission

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Roy C

Madras Medical Mission

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Sumithran G

Madras Medical Mission

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Kothandam Sivakumar

Madras Institute of Orthopaedics and Traumatology

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