Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature.

Stenotrophomonas maltophilia is known for nosocomial habitat. Infective endocarditis due to this organism is rare and challenging because of resistance to multiple broad-spectrum antibiotic regimens. Early detection and appropriate antibiotic based on culture sensitivity reports are the key to its management.

Coffin-Siris syndrome with the rarest constellation of congenital cardiac defects: A case report with review of literature.

We report a case of type-A Coffin-Siris syndrome (CSS) with a unique constellation of congenital heart defects. A 17-year-old Indian boy was referred to our hospital for central cyanosis with features of right heart failure. The cardiac abnormalities included biventricular outflow tract obstruction, small atrial septal defect (ASD), subaortic ventricular septal defect, drainage of left superior venacava to left atrial appendage, and aortic arch anomaly.

Reliability of Doppler-Based Measurement of Pulmonary Vascular Resistance in Congenital Heart Disease with Left-to-Right Shunt Lesions.

Background: Pulmonary vascular resistance (PVR) is a crucial parameter in the management of patients with left-to-right shunt lesions. Cardiac catheterization (Cath) is the gold standard test to assess PVR (PVRcath ), but it is invasive and hence, risky in children with pulmonary arterial hypertension (PAH). A noninvasive tool to assess PVR is desirable.

Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta.

Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA).

Pryce type I sequestration: no mosquito shooting.

We report a case of a 40-year-old woman with congenital dual arterial supply to an otherwise normal left lower lobe, causing hyperperfusion lung injury. In addition to near normal pulmonary arterial supply, the lower lobe of the left lung received a systemic arterial supply from the descending thoracic aorta. The patient was successfully managed by surgical ligation of the systemic arterial supply without lobectomy.

Renal angioplasty for atherosclerotic renal artery stenosis: Cardiologist's perspective.

Atherosclerotic renal artery stenosis (ARAS) is frequently associated with concomitant coronary and peripheral arterial disease with a significant impact on cardiovascular morbidity and mortality. Renal angioplasty of ARAS is more challenging because of increased incidence of technical failures, complications, and restenosis; while there is barely perceptible control of hypertension and only marginal improvement in renal function. This is because most of the patient population in recent randomized trials had unmanifested or clinically silent renovascular disease.

Prevalence of rheumatic and congenital heart disease in school children of Andhra Pradesh, South India.

Objective: To determine the prevalence of rheumatic heart disease (RHD) and congenital heart disease (CHD) using clinical and echocardiographic criteria in rural and urban school children in Andhra Pradesh, South India.

Materials And Methods: A total of 4213 school children between 5 and 16 years of age were screened. 1177 were from rural schools and 3036 from urban schools.

Brucella endocarditis - a series of five case reports.

Endocarditis due to brucellosis is considered a rare occurrence involving native, congenital and prosthetic valves. The diagnosis needs high degree of suspicion in culture negative endocarditis especially in those with history of exposure to farm animals. A positive culture in a susceptible patient confirms the diagnosis with 91% sensitivity.

Doehle-Heller aortitis: speed of decision is what saves life.

A 48-year-old woman presented with severe acute heart failure of 7 days duration. Because of her rapidly worsening clinical condition, anatomical diagnosis of aortopulmonary fistula was made by urgent cardiac catheterization, and she successfully underwent immediate surgical closure. Retrospectively, the diagnosis of syphilitic aortitis complicated with aortopulmonary fistula was made by clinical profile, serology, and histopathology.

Percutaneous closure of atrial septal defect via transjugular approach with Blockaid device in a patient with interrupted inferior vena cava.

Percutaneous ASD closure was successfully performed through the internal jugular approach in a 40-year old female with IVC interruption and azygos continuation. This case demonstrates the feasibility of transcatheter ASD closure in a difficult anatomy which precludes the standard transfemoral approach.

Device closure of post-myocardial infarction ventricular septal defect three weeks after coronary angioplasty.

Percutaneus device closure appears to be safe and effective in patients treated for a residual shunt after initial surgical closure, as well as after two to three weeks of index myocardial infarction. The index case presented with a ventricular septal defect on second of acute myocardial infarction thrombolysed with streptokinase. The general condition of the patient was fairly stable.

Fatal thrombocytopenia: A rare case with possible explanation.

A 22 year old male presented with breathlessness on exertion, ecchymosis, jaundice and features of worsening right heart failure for the last fifteen days. On physical examination, he had a mid diastolic murmur in the tricuspid area and an ejection systolic murmur in the pulmonary area. Bone marrow histopathology report showed an increased in megakaryocytes count.

A tetrad of bicuspid aortic valve association: A single-stage repair.

We report a 27 years old male who presented with a combination of both congenital and acquired cardiac defects. This syndrome complex includes congenital bicuspid aortic valve, Seller's grade II aortic regurgitation, juxta- subclavian coarctation, stenosis of ostium of left subclavian artery and ruptured sinus of Valsalva aneurysm without any evidence of infective endocarditis. This type of constellation is extremely rare.

A rare case of left lung hypoplasia associated with congenital pulmonary artery aneurysm and ventricular septal defect.

This report describes a 3-year-old boy who presented with hemoptysis and a history of congenital heart disease detected at the age of 3 months. Clinical and laboratory evaluation showed a large true congenital pulmonary artery aneurysm of the left main pulmonary artery occupying the entire left hemithorax and two small aneurysms in the right lung. In addition, a restricted ventricular septal defect was detected.

Myocardial infarction in children: Two interesting cases.

Myocardial infarction in children is extremely rare and can have various etiologies. The following two case reports highlight rare but important causes of myocardial infarction in children.

Gadolinium-enhanced three-dimensional magnetic resonance angiographic assessment of the pulmonary artery anatomy in cyanotic congenital heart disease with pulmonary stenosis or atresia: comparison with cineangiography.

Pulmonary stenosis (PS) or pulmonary atresia (PA) is an important component of complex cyanotic congenital heart disease, especially in tetralogy of Fallot or lesions with ventricular septal defect (VSD)-PS physiology. Management strategy in these patients depends on accurate assessment of PAs and identification of all sources of pulmonary blood flow. X-ray cineangiography is the "gold standard" for this purpose, but it has the inherent risks of an invasive procedure.

Endovascular stenting for native coarctation in older children and adolescents using adult self-expanding (Nitinol) iliac stents.

Background: The role of balloon-expandable stents for native coarctation has been proven in several small studies. Use of Nitinol-made self-expanding stents in such situations is reported in adults in only a few cases. For the last 5 years we used self expanding nitinol stents (primarily recommended for iliac angioplasty in adults in this condition in older children.

Balloon Mitral Valvuloplasty by Antegrade Technique in a Postoperative Patient Who Underwent Dacron Patch Closure of ASD.

A patient who underwent open-heart surgery for closure of secundum atrial septal defect and later developed rheumatic mitral stenosis has been subjected to balloon valvuloplasty by puncturing the interatrial septum in the standard fashion. This report discusses the pros and cons of the procedure.

Spontaneous dissection of coronary arteries.

Spontaneous dissection of coronary arteries is an uncommon entity with varied presentation. It is commoner in young patients, specially females. We present three cases encountered by us in recent past.

Validity and reproducibility of arterial pulse wave velocity measurement using new device with oscillometric technique: a pilot study.

Background: Availability of a range of techniques and devices allow measurement of many variables related to the stiffness of large or medium sized arteries. There is good evidence that, pulse wave velocity is a relatively simple measurement and is a good indicator of changes in arterial properties. The pulse wave velocity calculated from pulse wave recording by other methods like doppler or tonometry is tedious, time-consuming and above all their reproducibility depends on the operator skills.

Apical hypertrophic cardiomyopathy in association with Takayasu's arteritis.

We describe an interesting case of a patient who had Takayasu's arteritis and apical hypertrophic cardiomyopathy. Electrocardiogram, and transthoracic and transesophageal echocardiograms showed classical features of apical hypertrophic cardiomyopathy which is particularly uncommon outside Japan. To the best of our knowledge, the presence of apical hypertrophic cardiomyopathy in patients with Takayasu's arteritis has not been reported till date.