Publications by authors named "Joshi Shreedhar"

Objective: Many previous surveys have demonstrated a high incidence of burnout among anesthesiologists. The current survey was designed to estimate the incidence and understand the factors associated with burnout among cardiac anesthesiologists in India.

Design: Members of the Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA) were invited to participate.

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Objective: Postoperative atrial fibrillation (POAF) is associated with increased morbidity, mortality, and length of hospital stay. The objective of this study was to assess the utility of left atrial strain (LAS) to predict POAF in patients undergoing off-pump coronary artery bypass grafting (OPCABG).

Design: Retrospective observational study.

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Introduction: Left ventricular (LV) diastolic dysfunction is common on preoperative screening among patients undergoing surgery. There is no simple screening test at present to suspect LV diastolic dysfunction. This study was aimed to test the hypothesis, whether elastic recoil signal (ERS) on tissue Doppler imaging of mitral annulus (MA TDI) can be used as a qualitative test to differentiate patients from normal LV diastolic function versus patients with LV diastolic dysfunction.

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Objective: The objective of this multicenter study was to test the hypothesis of whether the use of a video laryngoscope (VL) reduces complications related to transesophageal echocardiography (TEE) probe insertion.

Design: A multicenter randomized control study.

Setting: At 5 tertiary care level hospitals.

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Background And Aims: Left ventricular (LV) systolic dysfunction is a common cause of hemodynamic disturbance perioperatively and is associated with increased morbidity and mortality. Echocardiographic evaluation of left ventricular systolic function (LVSF) has great clinical utility. This study was aimed to test the hypothesis that LVSF assessed by an anesthetist using mitral valve E Point Septal Separation (EPSS) has a significant correlation with that assessed using modified Simpson's method perioperatively.

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Background: Children with exposure to coronavirus disease 2019 in recent times (asymptomatic or symptomatic infection) approaching congenital heart surgery programme are in increasing numbers. Understanding outcomes of such children will help risk-stratify and guide optimisation prior to congenital heart surgery.

Objective: The objective of the present study was to determine whether convalescent coronavirus disease 2019 children undergoing congenital heart surgery have any worse mortality or post-operative outcomes.

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Objectives: Information on normative reference values for cardiac structures is critical for the accurate application of echocardiography for guiding clinical decision-making. Many studies using transthoracic echocardiography (TTE) have shown that Indians have smaller diameters of various cardiac structures. There are no normative studies for transesophageal echocardiography (TEE).

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Objective: Left ventricular diastolic dysfunction (LVDD) is very common among patients undergoing cardiac surgery and is associated with increased mortality and morbidity. The present study tested the hypothesis of whether left atrial strain (LAS) can be used as a single parameter to predict LVDD (per 2016 LVDD evaluation guidelines) and elevated left ventricular filling pressure (LVFP) (ie, LVDD grades II and III) in patients scheduled for off-pump coronary artery bypass grafting (OPCABG) surgery.

Design: A prospective observational study.

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Context: The cuff pressure (CP) of the endotracheal tube (ETT) exceeding 30 cm of HO results in reduced perfusion of lateral mucosa of trachea leading to complications. As the posterior tracheal wall is in contact with the esophagus, there is a possibility that the insertion of transesophageal echo (TEE) probe may compress the tracheal wall and increase CP.

Aims: This study was aimed to assess the impact of TEE probe insertion on CP in adults undergoing cardiac surgery.

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Article Synopsis
  • The study aims to analyze right ventricular (RV) function in patients undergoing off-pump coronary artery bypass grafting (OPCAB) before and after surgery.
  • Significant declines were observed in specific measures of RV systolic function (TAPSE and S') postoperatively, while other parameters of RV global function remained stable.
  • The overall findings indicate that RV diastolic function worsens after surgery, suggesting that RV function can be effectively evaluated during the perioperative period using echocardiography techniques.
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Background And Aims: Cardiac surgery associated acute kidney injury (CSA-AKI) is serious complication after cardiac surgery. The time interval between coronary angiography (CAG) to coronary artery bypass surgery (CABG) is proposed as modifiable risk factor for reduction of CSA-AKI. The aim of this study was to assess influence of time interval between CAG to off-pump CABG (OPCABG) on incidence of CSA-AKI.

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Context: Cardiac anesthesiologists play a key role during the conduct of cardiopulmonary bypass (CPB). There are variations in the practice of CPB among extracorporeal technologists in India. Aims: The aim of this survey is to gather information on variations during the conduct of CPB in India.

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Article Synopsis
  • The study investigated the effects of different levels of pulmonary arterial hypertension (PAH) on outcomes in Indian patients with rheumatic heart disease (RHD) who underwent cardiac surgery.
  • It analyzed data from 407 patients, categorizing them based on their pulmonary artery systolic pressure (PASP) and examining in-hospital mortality and long-term survival rates.
  • Results showed that while in-hospital mortality did not significantly differ across PAH categories, patients with mitral stenosis and severe PAH had notably higher long-term mortality, indicating that severe PAH does impact certain patient groups.
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Objectives: This study's objective was to test the hypothesis that transesophageal echocardiography (TEE)-based mitral annular plane systolic excursion (MAPSE) measurement is useful in perioperative settings to detect left ventricular (LV) systolic dysfunction in patients undergoing off-pump coronary artery bypass grafting (OPCAB).

Design: Retrospective observational study.

Setting: Tertiary-care level hospitals.

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Article Synopsis
  • The study tested whether pregabalin improves postoperative recovery quality in patients undergoing off-pump coronary artery bypass grafting (OPCABG), using the QoR-40 questionnaire for assessment.
  • Participants were randomly assigned to either a pregabalin group or a control group receiving placebos, with postoperative recovery evaluated 24 hours after extubation.
  • Results showed that the pregabalin group had significantly better recovery scores, particularly in emotional state, physical comfort, and pain management, suggesting that pregabalin is beneficial for patients post-surgery.
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Context: Use of perioperative transesophageal echocardiography (TEE) has expanded in India. Despite attempts to standardize the practice of TEE in cardiac surgical procedures, variation in practice and application exists. This is the first online survey by Indian College of Cardiac Anaesthesia, research and academic wing of the Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA).

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Context: One of the main limitations of off-pump coronary artery bypass grafting (OPCAB) is the occasional need for intraoperative conversion (IOC) to on-pump coronary artery bypass grafting. IOC is associated with a significantly increased risk of mortality and postoperative morbidity. The impact of IOC on outcome cannot be assessed by a randomized control design.

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A fistula between the right pulmonary artery and the left atrium is a very rare cause of central cyanosis. A clinical diagnosis is often made by first excluding other common causes and then performing diagnostic catheterization. Surgical closure offers a definitive cure for this rare congenital anomaly.

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Context: Left ventricle diastolic dysfunction (LVDD) is gaining importance as useful marker of mortality and morbidity in cardiac surgical patients. Different algorithms have been proposed for the intraoperative grading of DD. Knowledge of the particular grade of DD has clinical implications with the potential to modify therapy, but there is a paucity of literature on the role of diastolic function evaluation during off-pump coronary artery bypass grafting (OPCABG) surgery.

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Objective: Many observational studies have demonstrated an association between preoperative anemia and adverse outcomes after cardiac surgery. However, there is a paucity of data on the impact of anemia in patients undergoing cardiac surgeries for rheumatic heart disease (RHD). This study was designed to examine the prevalence and impact of preoperative anemia in patients undergoing cardiac surgery for RHD.

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Context: Perioperative period.

Aims: Occurrence of PPM after AVR, factors associated with PPM, impact on mortality.

Settings And Design: Teritary Care Referral Cardiac Centre.

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