Publications by authors named "Gurumurthy Hiremath"

Background: Growth is the holy grail of tissue implants in pediatrics. No vascular graft currently in use for surgical repairs of congenital heart defects has somatic growth capacity.

Methods: Biologically-engineered grafts (6 mm) grown from donor ovine fibroblasts in a sacrificial fibrin gel were implanted into the left pulmonary branch of 3-month old lambs for 3, 6, and 18 months.

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Thoracic endovascular aortic repair has emerged as a viable alternative for managing Sanford type B aortic dissection in adults. We report the first case of managing an acute and evolving communicating type B aortic dissection in an infant with endovascular aortic stenting.

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Background: With improved survival of adults with congenital heart disease (CHD) comes a need to understand the lifelong outcomes of this population. The aim of this paper is to describe the rationale and design of Congenital Heart Disease Project to Understand Lifelong Survivor Experience (CHD PULSE), a study to determine long-term medical, neurocognitive, and psychosocial outcomes among adults with a history of intervention for CHD and to identify factors associated with those outcomes.

Methods: CHD PULSE is a cross-sectional survey conducted from September 2021 to April 2023 among adults aged 18 and older with a history of at least 1 intervention for CHD at 1 of 11 participating U.

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In this paper, we share our single-center experience of successful multidisciplinary management of patients with Alagille syndrome. In addition, we aim to highlight the need for an Alagille program for effectively managing these patients, in general, and particularly peripheral pulmonary artery stenosis associated with this syndrome. This is a retrospective review of six children with Alagille syndrome and advanced liver involvement who underwent pulmonary artery reconstruction between 2021 and 2022.

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A 49-year-old man presented late with an anterior wall myocardial infarction (MI) status post-primary coronary intervention of the left anterior descending artery that resulted in no reflow of the vessel. The patient was transferred to our institution in cardiogenic shock.

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Infective endocarditis (IE) associated with an ASD device, particularly in the early post-procedure period, is extremely rare. We report a case of infective endocarditis presenting with embolic complications and vegetations on the device that were only seen on transesophageal echocardiography, necessitating device removal.

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Article Synopsis
  • - Ventricular pressure-volume (PV) loops provide valuable information about how the heart functions and how it can be affected by various conditions.
  • - These loops are particularly useful for understanding congenital heart diseases, like single ventricular physiology, heart failure, and pulmonary hypertension.
  • - The review emphasizes both the theory and practice of obtaining and interpreting PV loops, highlighting their significance in clinical settings and guiding treatment decisions.
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Background: Paediatric studies have shown serum N-terminal pro b-type natriuretic peptide levels to be a valuable tool in the surveillance of myocardial function and an early biomarker for rejection in transplant patients. The correlation between low mean right atrial pressure and increased inferior vena cava collapsibility index is well studied in adults. Our study aims to assess correlation between non-invasive measurements (serum N-terminal pro b-type natriuretic peptide, inferior vena cava dimensions collapsibility, tricuspid regurgitation, and left ventricular remodelling index to invasive mean right atrial pressure in paediatric heart transplant patients).

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Obstructed total anomalous pulmonary venous connection (TAPVC) represents a true pediatric cardiac emergency. The patient may present in extremis secondary to severe pulmonary hypertension and cardiogenic shock which increases perioperative mortality. We present a neonate who underwent a successful staged hybrid approach for an Infradiaphragmatic obstructed TAPVC.

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Background: The Inspiris Resilia (Edwards Lifesciences LLC) bioprosthesis has gained widespread use in the aortic position; however no robust data are available about its use in the pulmonary position.

Methods: We reviewed our outcomes for the Inspiris Resilia in the pulmonary position between August 2019 and October 2021.

Results: Twenty-seven patients (15 female patients [56%]; mean age, 22.

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Background: Patients with atrial septal defects and pulmonary hypertension would benefit from early identification and treatment of pulmonary hypertension prior to closure. Noninvasive screening tools for pulmonary hypertension are inadequate. Electrocardiography, though readily available, has so far been of limited screening utility in patients with pulmonary hypertension.

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Article Synopsis
  • Right ventricular pressure-volume (PV) analysis assesses the heart's pumping abilities regardless of external factors like blood volume and pressure.
  • It has historically been a complex technique used mainly in research, but advancements in technology have made it more accessible for clinical use.
  • The review highlights foundational techniques for measuring and interpreting PV loops, explores its clinical applications, and emphasizes its significance in understanding right ventricular function in various health contexts.
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Article Synopsis
  • Neonates and infants with coronary artery fistulas (CAFs) are rare, and this study examines their outcomes post-treatment through a retrospective review.
  • Out of 48 patients analyzed, most had proximal CAFs, with high procedural success rates for both transcatheter (92%) and surgical closure (94%).
  • Follow-up results showed that while a majority had optimal coronary remodeling, those with distal CAFs experienced more complications, including symptomatic and asymptomatic thrombosis.
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Background: Achieving successful repair of congenital heart defects requires attention to detail. Careful evaluation of anastomotic site patency, reimplanted coronary arteries, location of epicardial coronaries, and myocardial perfusion may be necessary to ensure safe conduct of the operation and achieve excellent outcomes.

Methods: Intraoperative fluorescence angiography (IOFA) was performed using indocyanine green in patients undergoing the following procedures: coronary artery reimplantation, coronary artery unroofing, evaluation of intraoperative coronary anatomy, reoperation requiring ventriculotomy, coarctation/interrupted aortic arch repair, systemic-to-pulmonary artery shunt, Norwood procedure, thoracic duct localization, and vascular rings.

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Introduction: The Nit-Occlud PDA device is a newer coil-type device with a high degree of efficacy and safety. There are concerns about the high incidence of immediate angiographic residual shunt with this device.

Aim: To compare immediate angiographic residual shunts and their outcomes following PDA device closure with the Nit-Occlud device.

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Pericardiocentesis is traditionally performed using a subxiphoid approach. Hepatomegaly or loculated and noncircumferential effusions warrant nonstandard approaches to drain effusions; echocardiographic guidance has made these less traditional, non-subxiphoid approaches feasible. The study is aimed at comparing clinical outcomes of the subxiphoid and non-subxiphoid approaches to percutaneous pericardiocentesis in a pediatric population.

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Objective: Median sternotomy has been the standard for pulmonary valve replacement (PVR) in patients with free pulmonary regurgitation (PR) and right ventricular enlargement. With the introduction of transcatheter therapy, the search for an alternate to sternotomy is mandated. We present our early experience with a limited anterior left thoracotomy approach.

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• Coronary artery anomalies may exist with congenital PS. • PS occurs in both animals and humans. • Transpulmonary stenting may be considered in dogs with PS and coronary anomalies.

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Introduction: Pediatric patients with cardiomyopathies are at risk for sudden death and may need implantable cardioverter defibrillators (ICD's), but given their small size and duration of use, children are at increased risk for complications associated with ICD use. The subcutaneous ICD presents a favorable option for children without pacing indications. Unfortunately, initial pediatric studies have demonstrated a high complication rate, likely due to the 3-incision technique employed.

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Objectives And Background: Coarctation of the aorta represents 5-8% of all congenital heart disease. Although balloon expandable stents provide an established treatment option for native or recurrent coarctation, outcomes from transverse arch (TAO) stenting, including resolution of hypertension have not been well studied. This study aims to evaluate immediate and midterm results of TAO stenting in a multi-center retrospective cohort.

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Myocardial bridging is a controversial topic that remained with no well-defined management protocol. We present a ten-year-old child with Noonan syndrome and a myocardial bridge.

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Synopsis of recent research by authors named "Gurumurthy Hiremath"

  • - Gurumurthy Hiremath's recent research focuses on innovative approaches in pediatric cardiology, particularly in managing congenital heart defects through engineered solutions and minimally invasive techniques.
  • - His studies highlight the integration of advanced technologies, such as biologically-engineered vascular grafts and novel retrieval devices, aiming to improve outcomes in surgeries involving congenital heart conditions and post-operative evaluations.
  • - The findings emphasize the importance of understanding long-term consequences for survivors of congenital heart disease and the need for collaboration in managing complex syndromes like Alagille syndrome, reflecting a commitment to enhancing patient care throughout their lifetime.