Isolated unilateral pulmonary artery atresia with contralateral pulmonary artery branch stenosis: A "window" for intervention.

Adult presentation of unilateral pulmonary artery atresia in association with contralateral branch pulmonary stenosis is rare. We present the case of a quadragenarian, who manifested with right ventricular failure and hemoptysis. This report discusses the diagnostic workup and therapeutic options along with a brief overview of the concerned literature.

Impact of COVID-19 on heart failure hospitalization and outcome in India - A cardiological society of India study (CSI-HF in COVID 19 times study - "The COVID C-HF study").

Objectives: The presentation and outcomes of acute decompensated heart failure (ADHF) during COVID times (June 2020 to Dec 2020) were compared with the historical control during the same period in 2019.

Methods: Data of 4806 consecutive patients of acute HF admitted in 22 centres in the country were collected during this period. The admission patterns, aetiology, outcomes, prescription of guideline-directed medical therapy (GDMT) and interventions were analysed in this retrospective study.

COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA).

Objective: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period.

Methods: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control.

Neutrophil Gelatinase-Associated Lipocalin as a Marker for Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention: A Prospective Observational Analysis.

Introduction: Incidence of contrast-induced nephropathy (CIN) post percutaneous coronary intervention (PCI) varies between 5% and 20%. Neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive marker for acute kidney injury. Data regarding the predictive accuracy of NGAL in Indian patients undergoing PCI is sparse.

Post-stenting angiographically silent coronary dissection: OCT comes to the rescue.

Stent edge dissection is one of the procedural complications concerning percutaneous coronary intervention (PCI). We present a clinical case of multi-vessel PCI where the patient had to return with recurring symptoms within two weeks of a seemingly successful PCI, only to teach us a valuable lesson in the more frequent and judicious use of intracoronary imaging.

Comparison of non-invasive assessment for pulmonary vascular indices by two-dimensional echocardiography and cardiac computed tomography angiography with conventional catheter angiocardiography in unrepaired Tetralogy of Fallot physiology patients weighing more than 10 kg: a retrospective analysis.

Aims: Assessment of pulmonary vascular dimensions (PVDs) in Tetralogy of Fallot (TOF) is an integral part of planning transcatheter and surgical interventions. We sought to examine the reliability and correlation of echocardiography (ECHO) and computed tomography angiography (CTA) measurements with those obtained by cardiac catheterization and angiography (CCA).

Methods And Results: Tetralogy of Fallot physiology patients undergoing ECHO, CTA, and CCA within a month prior to surgical correction during 2018-2020 were retrospectively enrolled.

Guiding Principles for the Clinical Use and Selection of Microcatheters in Complex Coronary Interventions.

The use of microcatheters as a coronary interventional tool for a therapeutic approach to complex coronary interventions like bifurcation lesions, ostial location, tortuous anatomy, angled takeoffs, coronary calcification, and chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is growing among cardiologists across the country. During the treatment of such complex lesions, microcatheters play an essential part of the tool kit with both single-lumen and double-lumen microcatheters (DLMs) having their specific niche areas. The selection of microcatheters involves a detailed understanding of the microcatheter specification, lesion anatomy, lesion location, vessel tortuosity and trajectory, and crossing techniques.

Vascular dysfunction and its recovery after transradial coronary angioplasty- A serial observational study.

Objective: To serially evaluate the effect of trans-radial coronary angioplasty (TRA) on the vascular function of radial artery (RA) and upstream brachial artery (BA) and to find out the relative contribution of endothelial dependent flow-mediated vasodilatation (FMD) and endothelial independent nitrate mediated dilatation (NMD).

Methods: Forty patients of chronic stable angina with successful TRA were studied. FMD and NMD of bilateral RA and BA were measured with high-resolution ultrasound, before and at 24 h and at 3 months, after catheterization.

Left main coronary artery diameter - A correlation between intravascular ultrasound and quantitative coronary angiography.

Coronary angiography mostly underestimates coronary artery size. Indian data is scarce on correlating quantitative angiographic coronary diameter (D) to intravascular ultrasound derived coronary diameter (D). We retrospectively analyzed 10-year data (2008-2017) of patients undergoing IVUS guided left main percutaneous coronary intervention (LM-PCI).

Acromegaly: Cardiovascular risk factors, cardiovascular manifestations and early vascular alterations in relation to disease activity.

Acromegaly is associated with increased cardiovascular morbidity and mortality. 49 acromegaly patients were evaluated for presence of cardiovascular risk factors and manifestations using 2D-Echocardiography, strain, strain-rate, carotid intima media thickness (CIMT) and flow mediated dilatation (FMD) and correlated with disease activity. 32 patients with growth hormone (GH) level >1 ng/ml were considered active.

Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review.

The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.

Maternal and fetal outcomes in pregnant females with rheumatic heart disease.

Background: Cardiac diseases are seen in 1-3% of pregnancies. In developing countries rheumatic heart disease (RHD) contributes a major cause of cardiac disorders.

Objective: To study the maternal and fetal outcome in women with valvular heart disease or prosthetic heart valve replacement secondary to RHD in a tertiary care center.

Use of strain, strain rate, tissue velocity imaging, and endothelial function for early detection of cardiovascular involvement in young diabetics.

Background: Subtle structural and functional changes may precede the onset of overt global left ventricular (LV) dysfunction. Data pertaining to tissue velocity imaging (TVI)and strain imaging to assess regional myocardial function and flow mediated vasodilatation are limited in young patients with diabetes.

Materials: Conventional echocardiography, TVI parameters along with strain (S), and strain rate (SR) were measured in 50 young diabetics (15.

Arterial Anomalies of the Upper Limb and Their Influence on Transradial Coronary Procedures.

Objectives: During transradial coronary procedures, arterial anomalies of the upper limb can lead to transradial navigation difficulties. We aimed to evaluate the incidence and impact of these anomalies on transradial procedures.

Methods: In consecutive patients undergoing transradial coronary procedures, antegrade upper-limb arterial angiography was done at the end of the procedure with the catheter tip in the subclavian artery.

Effect of statin on perioperative myocardial injury in isolated valve surgery.

Background: Statins have known pleiotropic effects that confer protection from ischemia-reperfusion injury. Because cardiopulmonary bypass is a potentially reversible ischemia-reperfusion sequence, we aimed to assess whether statin loading could help to limit myocardial injury in patients undergoing isolated heart valve replacement under cardiopulmonary bypass.

Methods: One hundred patients with rheumatic valvular heart disease undergoing valve replacement received either a loading dose of rosuvastatin (40 mg initiated 7 days before surgery; loaded group) or no statins (non-loaded group).

Impact of percutaneous coronary intervention on patients with impaired baseline renal function.

Background: Acute kidney injury (AKI) frequently co-prevails with acute coronary syndromes (ACS), which could improve post percutaneous coronary intervention (PCI). We sought to evaluate the impact of PCI on post-procedural renal function in patients with impaired baseline serum creatinine (Cr).

Methods: Retrospective evaluation of 185 patients undergoing PCI with impaired basal serum Cr (≥ 1.

Etiology and distribution of isolated aortic stenosis in Indian patients - A study from a large tertiary care hospital in north India.

Background: Isolated aortic valve disease (IAVD) has traditionally been a disease of elderly, etiology being either senile degeneration of a tricuspid aortic valve or calcification of a bicuspid aortic valve. However, there is scarcity of Indian data regarding demographic distribution and etiological patterns of IAVD in context of emerging therapies like transcatheter aortic valve implantation (TAVR).

Methods & Results: A retrospective observational analysis of 60,560 echocardiograms over three years revealed 3728 newly diagnosed cases of valvular heart disease (VHD).

Immediate and long-term outcomes of balloon mitral valvotomy in pregnancy.

Objectives: To study the immediate maternal and fetal outcomes and long term maternal outcomes in pregnant women undergoing balloon mitral valvotomy.

Methods: We retrospectively analyzed balloon mitral valvotomy during pregnancy performed between January 2008 and July 2018.

Results: BMV was carried out in 97 pregnant women with mean age of 26.

First-in-human evaluation of a novel balloon-expandable transcatheter heart valve in patients with severe symptomatic native aortic stenosis: the MyVal-1 study.

Aims: The aim of this study was to demonstrate the safety and efficacy of the next-generation balloon-expandable Myval transcatheter heart valve (THV) in an intermediate- or high-risk patient population with severe symptomatic native aortic stenosis.

Methods And Results: MyVal-1 was a first-in-human, prospective, multicentre, single-arm, open-label study. Between June 2017 and February 2018, a total of 30 patients were enrolled at 14 sites across India.

Incidence and predictors of forearm hematoma during the transradial approach for percutaneous coronary interventions.

Background: The transradial approach for percutaneous coronary intervention (TRA-PCI) reduces vascular complications compared with the transfemoral approach (TFA). Although hematoma formation is less frequent with the TRA than TFA, it is not uncommon, and its presentation ranges from mild hematoma to compartment syndrome. Incidence and predictors of hematoma have not been well studied.