Comparison of Levosimendan Versus Milrinone After the Arterial Switch Operation for Infants ≤3 kg.

Various inotropes and inodilators have been utilized to treat low cardiac output syndrome after the arterial switch operation. The use of levosimendan, a calcium sensitizer has been limited in this setting. This study compares the effects of levosimendan with milrinone in managing low cardiac output after the arterial switch operation.

Chylothorax in Infants and Children After Congenital Heart Surgery: Approach and Review.

Chylothorax in infants after surgery for congenital heart disease is associated with significant morbidity and mortality. Numerous management modalities applied alone or in various combinations have been utilized but definitive guidelines have not yet been established. We present two infants who developed refractory chylothorax after congenital heart surgery.

"Prolonged" venoarterial extracorporeal membrane oxygenation support for respiratory failure: Outcome in an infant.

Extracorporeal membrane oxygenation (ECMO) is a form of extracorporeal life support which provides cardiorespiratory support to patients with potentially reversible pathophysiological processes. ECMO has evolved over the past few decades as a standard technology for neonatal severe respiratory support. However, its use in the pediatric population has increased only since 2009.

Perfusion Strategy to Prevent Right Ventricular Decompression on Cardiopulmonary Bypass During Extracardiac Fontan for Right Ventricle-Dependent Coronary Circulation.

Early and long-term outcomes in patients with pulmonary atresia-intact ventricular septum undergoing staged univentricular palliations have been known to be adversely affected by the presence of right ventricle-dependent coronary circulation. We describe a surgical technique to circumvent the coronary insufficiency caused by acute decompression of the right heart.

Strategies to mitigate inflammation in management of complex congenital heart disease complicated by "multisystem inflammatory syndrome in children".

A 6-month-old boy, a case of Shone's complex, presented in decompensated state was found to have severe mitral stenosis along with multisystem inflammatory syndrome in children (MISC) warranting urgent surgical intervention. Various modalities including cytokine-adsorbing hemofilter were used to target inflammation. Postoperatively, the child recovered from low cardiac output accompanied by decrease in the levels of inflammatory markers, inopressors, and ventilatory requirements.

Outcomes of primary repair of sternal cleft defects: Providing a "bony cover".

Background: Sternal clefts are rare congenital anterior chest wall defects created by a lack of midline thoracic fusion. Various surgical repairs have been proposed to provide protection to underlying viscera in these defects.

Aim: This study aims to perform primary sternal cleft repair using techniques, leading to the provision of a complete bony cover and to assess their outcomes on follow-ups.

Impact of irradiation on physico-chemical and nutritional properties of fruits and vegetables: A mini review.

Background: Fruits and vegetables are healthy because they contain good nutrients and secondary metabolites that keep the body healthy and disease-free. Post-harvest losses of fresh fruits and vegetables limit access and availability as a result of foodborne infections and poor storage technologies. The selection of fruits and vegetables depend on the starting microbial load, the size of fruits and vegetables, and the type of infrastructure.

Endovascular stent implantation as a primary method of treatment for blocked modified Blalock‒Taussig shunt.

Modified Blalock‒Taussig shunt is a commonly performed palliative cardiac surgery. Complications like early or late occlusion have been reported in approximately 10% of patients. Thrombosis, stenosis, or kinking are possible mechanisms that lead to shunt obstruction which may be life-threatening and need urgent intervention in form of medical, surgical, or interventional catheterization.

Structural Features of Coronavirus and the COVID-19 Pandemic's Impact in India.

The rapid transmission of COVID-19 infection around the world in a brief timeframe has caused an exponential decline in street traffic and other industrial activities in various parts of the world. The confined human collaboration with the nature at the time of this emergency has shown up as an advantage for Mother Nature after COVID-19 flare because the air present in the atmosphere and water flowing in river streams is upgrading and untamed life is blossoming. India, being consistently seen as the center of contamination due to a tremendous population, overwhelming road traffic and industries which contribute to heavy pollution prompting rise in air quality index for almost all the big cities of the country.

Techniques to avoid hypothermic circulatory arrest in the management of renal tumor with right atrium extension in children.

Clear cell sarcoma of the kidney is a rare variety of renal tumor accounting for less than 5% of all pediatric renal tumors. Cardiopulmonary bypass along with hypothermic circulatory arrest is frequently used for management of tumor thrombus extending into supra-hepatic inferior vena cava and right atrium. In this paper, we present a strategy of avoiding circulatory arrest and hypothermia and thereby fast-tracking the recovery in managing a case of clear cell sarcoma of the kidney in a 3.

Anesthesia protocols for "bedside" preterm patent ductus arteriosus ligation: A single-institutional experience.

Background: Hemodynamically significant patent ductus arteriosus (PDA) is frequently encountered in preterm infants sometimes requiring surgical attention. Although PDA ligation is regularly performed in the operating room, conducting it at the bedside in a neonatal intensive care unit (NICU) and its anesthetic management remains challenging.

Aim: We aim to discuss the anesthetic considerations in patients undergoing bedside PDA ligation and describe our experience highlighting the feasibility and safety of this procedure.

A review of the Yasui operation with long-term follow-up of a case.

Unlabelled: Yasui operation combines Norwood arch reconstruction with Rastelli operation for interrupted or hypoplastic aorta with aortic valvar atresia or hypoplasia with ventricular septal and two adequately sized ventricles, establishing biventricular repair. We present a case of aortic atresia, mitral hypoplasia, and ventricular septal defect (VSD) treated by Yasui procedure, and its long-term (108 months) follow-up and brief review of literature. Review of literature was done using keywords to search on "PubMed" and "Google Scholar.

Axillary arterial access for balloon dilatation of coarctation of aorta in newborns: a case series.

Balloon dilatation of coarctation of aorta is a standard of care for the patients presenting with severe left ventricular dysfunction. It can be performed through femoral, carotid, and axillary arterial access. Very few case series were available in the literature through axillary arterial access, despite being its advantage as non-end artery and easily palpable in coarctation of aorta.

Techniques to repair parachute tricuspid valve.

Parachute deformity of atrioventricular valve occurs when chordae tendineae arise either from one papillary muscle or a closely placed muscle group. Preoperative detection is easier with mitral involvement than with tricuspid valve. We present two cases of parachute tricuspid valve (PTV) which were successfully repaired.

Aneurysm of Pulmonary Sinus of Valsalva: Successful Management of a Case.

Pulmonary sinus of Valsalva aneurysm is an extremely rare entity, reported only twice in the literature. It can remain asymptomatic or can present with symptoms when associated with pulmonary artery aneurysms. We present a case of pulmonary sinus of Valsalva aneurysm causing severe right ventricular outflow tract obstruction.

Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)-A Randomized Controlled Trial.

Background: There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes.

Methods: Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital.

Noninvasive Assessment of Liver Stiffness in Patients Undergoing the Fontan Procedure.

Background: Hepatic derangements and liver injury following the Fontan operation (FO) may progress in some cases to hepatic fibrosis (HF) and cirrhosis. The respective roles of transient elastography (TE) or FibroScan, shear wave elastography (SWE), and aspartate transaminase to platelet ratio index (APRI) in assessing liver stiffness (LS) and possible liver injury in these patients are unclear.

Methods: Thirty-nine patients (31 males), mean age 11.

Flexible Fiber-optic Bronchoscopy-directed Interventions in Children with Congenital Heart Diseases.

Objective: In children, pulmonary and cardiac diseases are closely associated, and their integrated evaluation is important. Flexible fiber-optic bronchoscopy (FFB) can be used for both diagnostic and therapeutic purposes in pediatric cardiac intensive care units (PCICU). The objective of this study was to evaluate the utility of FFB in children with congenital heart disease (CHD).

Indian Guidelines for Indications and Timing of Intervention for Common Congenital Heart Diseases: Revised and Updated Consensus Statement of the Working Group on Management of Congenital Heart Diseases. Abridged Secondary Publication.

Justification: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition.

Near-infrared spectroscopy: An important tool during the blalock-taussig shunt.

Near infra red spectroscopy (NIRS) is a noninvasive diagnostic tool for measuring regional oxygen saturation (rSO2). Cerebral oxygenation measured with NIRS is used to corroborate mixed venous oxygenation and hence considered an indicator of tissue perfusion. We describe NIRS guiding an anatomical variation leading to inadequate cerebral circulation or any impairment in cerebral oxygen delivery during Blalock Taussig shunt.

Guidelines for the management of common congenital heart diseases in India: A consensus statement on indications and timing of intervention.

Introduction: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition.

Complete transposition of great arteries associated with total anomalous pulmonary venous connection: An unusual cause for early left ventricular myocardial mass regression.

A 24-day-old apparently asymptomatic neonate was found to have complete transposition of great arteries with small patent ductus arteriosus and restrictive patent foramen ovale. The neonate was found to have relatively high saturations (saturations = 88%) despite inadequate mixing communications. Echo findings were suggestive of significant dilatation of right atrium and right ventricle and left ventricular (LV) mass regression.