Suresh Patted

Candida krusei infection presenting as a right ventricular mass in a two month old Infant

The prevalence of fungal infections in newborns and small infants is on the rise consequent to the improved care and survival of preterm babies. Most of these premature infants are immunocompromised and subjected to invasive monitoring and therapy in neonatal intensive care units making them susceptible to nosocomial infections. We report a rare case of right ventricular mass secondary to candida krusei infection which was excised surgically. This article reemphasizes the importance of stringent aseptic practices in neonatal intensive care units to prevent nosocomial infections and the early use of echocardiography in neonates presenting with atypical unexplained symptoms to hasten diagnosis and facilitate timely intervention.

Transcatheter occlusion of multiple pulmonary arterio venous malformations.

Pulmonary arterio venous malformations are one of the rare vascular anomalies. Usually single large pulmonary arteriovenous fistula (PAVF) can be closed through transcatheter route but multiple PAVF require surgical lobectomy. We describe a case of an 8-year-old boy with multiple PAVF, who underwent successful transcatheter closure with multiple coils.

Twin heart with a fused atria and separate ventricles in conjoined twins

One of the most interesting congenital malformations is that of conjoined twins. We report echocardiographic features of twin heart in dicephalus, tribrachius, dispinous, thoracoomphalopagus twin. It showed two hearts fused at atrial level. Right-sided heart had single atrial chamber with a single ventricle. A single great vessel, aorta, originated from it. Left-sided heart was well developed with two atria and two ventricles. There was a small mid muscular ventricular septal defect and a small patent ductus arteriosus. Great arteries had normal origins.

Definitive treatment of lutembacher syndrome

Atrial septal defect (ASD) with rheumatic mitral stenosis is popularly known as eponym of Lutembacher syndrome. Definitive treatment of Lutembacher syndrome has been under the purview of cardiothoracic surgeons but with changing times, transcatheter treatment has been possible. We present a case of 38-year-old female with Lutembacher syndrome treated transcatheterly. This case attests the feasibility of transcatheter treatment in selected group of patients of Lutembacher treatment.

PREVALENCE OF TRICUSPID VALVE DISEASE IN RHEUMATIC HEART DISEASE

To study the incidence of tricuspid valve disease (TVD) in patients with rheumatic heart disease (RHD). Tricuspid valve disease is also involved in chronic RHD with coexistence of mitral & aortic valve disease. The natural course of patient with Tricuspid valve disease is not well defined. We

Successful Treatment of Double-Orifice Mitral Stenosis with Percutaneous Balloon Mitral Commissurotomy

Double-orifice mitral valve (DOMV) is an uncommon congenital anomaly, being present in 0.05% of the general population. The isolated occurrence of this anomaly is very rare and, to our knowledge, no data are currently available on the incidence of an isolated DOMV. A DOMV is characterized by a mitral valve with a single fibrous annulus with 2 orifices opening into the left ventricle (LV). Subvalvular structures, especially the tensor apparatus, invariably show various degrees of abnormality. It can substantially obstruct mitral valve inflow or cause mitral valve incompetence. We present a rare case of nineteen-year-old male who underwent percutaneous mitral balloon commissurotomy in stenotic DOMV.

A case of symptomatic double coronary artery-pulmonary artery fistulae.

A 57-year-old lady presenting with angina was found to have multiple coronary arterio venous fistulae (CAVF) arising from both left and the right coronary arteries and draining into the pulmonary artery. She underwent successful surgical closure of these CAVF.

Successful deployment of a dislodged sirolimus-eluting stent with a small-balloon technique

Stent dislodgement is a rare but recognized and potentially serious complication of percutaneous coronary intervention. Stent dislodgement was more frequent in the past when stents were manually crimped onto the balloon. Newer and improved balloon-mounted stents with better radio-opacity have reduced the incidence of stent dislodgement but do not completely eliminate it. We report a case of stent dislodgement which was successfully deployed with small-balloon technique. This patient however was successfully treated with small balloon technique at the desired site. <Learning objective: Newer and improved balloon-mounted stents with better radio-opacity have reduced the incidence of stent dislodgement but do not completely eliminate it.>.

Percutaneous mitral balloon valvotomy in a case of situs inversus dextrocardia with severe rheumatic mitral stenosis

The efficacy, safety and applicability of Inoue balloon technique for BMV are clearly established worldwide in selected subset of patients with rheumatic mitral stenosis (MS). However, in altered cardiac anatomy it offers technical challenges. Distorted cardiac anatomy and cardiac malpositions considerably increase the complications involved in interatrial septal puncture and left ventricular entry during BMV. There are only a few reports worldwide on successful BMV in altered cardiac anatomy using the standard Inoue technique. Here we describe a case of a 27-year-old female with situs inversus and dextrocardia, where BMV was successfully performed with a few modifications of the standard Inoue technique previously described in similar patients.

JNC-7 definition of hypertension needs alteration

Abstract OBJECTIVES By altering JNC-7 definition of hypertension as per our modified definition, we tried to find out the difference in prevalence of hypertension. Our modified definition is 1 mmHg less than JNC-7 criteria. METHODS We did the analysis of data collected in Belgaum Hypertension Prevalence Study conducted by KLE University Belgaum; to know the difference between the JNC-7 classified group and modified classification what we thought can change the hypertension statistics. RESULTS According to JNC-7, only 16.3% population in our study were in normal group while 41.1% had come in pre-hypertension group and 42.6% were in hypertensive group. According to our proposed modified definition, nearly double the populations i.e. 37.4% were in normal group, 40.2% remained in pre-hypertension group and only 22.4% were in hypertension group. CONCLUSION This statistics significantly altered prevalence of hypertension from 42.6% to 22.4% indicating that by making 1 mmHg alteration in number, the prevalence could be brought down by 20.2%. This simple alteration of figure by 1 mmHg can put more than 20% of people in normal group as compared to pre-hypertensive group of JNC-7, thereby reducing the agony and psychological torture.