Training and mentoring of the congenital heart surgeon for India.

Congenital heart surgery is one of the most demanding subspecialities in surgery. To become a competent surgeon, a lot of investment of time, in-depth study, training under a committed mentor, acquisition of the necessary fine surgical skills, and development of a three-dimensional appreciation of corrections are needed to be cultivated. These make it not only a speciality of skills, but also a cerebral speciality.

Impact of COVID-19 pandemic on pediatric cardiac services in India.

Background: COVID-19 pandemic has disrupted pediatric cardiac services across the globe. Limited data are available on the impact of COVID.19 on pediatric cardiac care in India.

Coronary transfer in the arterial switch operation: the modified closed technique.

Arterial switch operation for transposition of great arteries (TGA) is the choice of surgical treatment for this condition. Conventional "open" coronary transfer technique has been commonly employed with good results in experienced hands. A modified "closed" technique of coronary transfer, with a more accurate coronary artery placement taking into account a distended aorta, along with anterior interrupted sutures to reduce purse stringing and other advantages is described.

A single center, retrospective analysis of total anomalous pulmonary venous connection repair early outcome at a tertiary care center in India.

Context: In recent years, increasing awareness and early detection has made total anomalous pulmonary venous connection (TAPVC) a relatively common congenital heart condition presenting to children's heart centers in India. The condition was associated with significant morbidity and mortality in the past due to various reasons. Improvement in perioperative management has markedly changed the outcomes of TAPVC even in a developing country.

Hypoplastic left heart syndrome: current modalities of treatment and outcomes.

Hypoplastic left heart syndrome is a constellation of malformations which result from the severe underdevelopment of any left-sided cardiac structures. Once considered to be universally fatal, the prognosis for this condition has tremendously improved over the past four decades since the work of William Norwood in the early 1980s. Today, a staged surgical approach is applied for palliating this distinctive cohort of patients, in which they undergo three operative procedures in the first 10 years of their life.

Single-Stage Repair of Interrupted Aortic Arch With Aortopulmonary Window and Bovine-Type Aortic Arch Complicated by Left Subclavian Artery Origin Stenosis-A Case Report.

An aortopulmonary window is known to be associated in 5% of interrupted aortic arch cases. The combination of these lesions with a bovine-type aortic arch is much more uncommon. We report its embryological explanation and successful single-stage surgical repair in a three-month-old infant.

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.

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.

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.

A number of guidelines are available for the management of congenital heart diseases (CHD) 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 CHD, as often these patients present late in the course of the disease and may have coexisting morbidities and malnutrition.

Native aortic coarctation in neonates and infants: Immediate and midterm outcomes with balloon angioplasty and surgery.

Background: Native aortic coarctation in young infants can be treated surgically or with balloon angioplasty, although the latter approach remains controversial. We sought to compare midterm outcomes of balloon and surgical coarctoplasty at our center and to review the current practices in literature.

Methods: The study design was a retrospective record review.

Neonates with critical congenital heart defects: Impact of fetal diagnosis on immediate and short-term outcomes.

Background: Fetal echocardiography is being increasingly used for prenatal diagnosis of congenital cardiac malformations, but its impact on the neonatal outcomes in low- and middle-income countries is still unknown.

Aims: The objective of this study is to determine the impact of fetal echocardiography on immediate postnatal and short-term outcome in a tertiary pediatric cardiac center.

Study Design: This is a prospective study.

Isolated Subclavian Artery: A Rare Entity Revisited.

Isolation of the subclavian artery is a rare aortic arch anomaly with fewer than 100 cases reported in the literature. Left subclavian artery isolation is seen in 0.8% of right aortic arches, and right subclavian artery isolation is seen four times less frequently.

Rare associations of tetralogy of Fallot with anomalous left coronary artery from pulmonary artery and totally anomalous pulmonary venous connection.

We describe the cases of two patients with tetralogy of Fallot, aged 4 years and 8 months, who were incidentally detected to have concomitant anomalous left coronary artery from pulmonary artery and total anomalous pulmonary venous connection, respectively, on preoperative imaging. They underwent surgical correction with good mid-term outcomes. In this study, we discuss the embryological basis, physiological effects, and review the literature of these two unusual associations.

Effect of dexmeditomidine on postoperative junctional ectopic tachycardia after complete surgical repair of tetralogy of Fallot: A prospective randomized controlled study.

Introduction: Incidence of junctional ectopic tachycardia (JET) after repair of tetralogy of Fallot (TOF) is 5.6-14%. Dexmeditomidine is a a-2 adrenoceptor agonist modulates the release of catecholamine, resulting in bradycardia and hypotension.

Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention.

Objective: To identify determinants of malnutrition in children with congenital heart disease (CHD) and examine the short-term effects of corrective intervention.

Methods: Patients with CHD admitted for corrective intervention were evaluated for nutritional status before and 3 months after surgery. Detailed anthropometry was performed and z-scores calculated.

Determinants of early outcome after neonatal cardiac surgery in a developing country.

Objective: Significant technologic advances have improved outcomes in neonatal cardiac surgery over the past 3 decades. However, outcomes might be different in developing countries with resource limitations. We sought to identify the determinants of early outcome after neonatal cardiac surgery in a tertiary referral center in South India.

Pediatric cardiac surgery in developing countries.

Pediatric cardiac surgery in developing countries is a major challenge. It is a challenge to employ evolving methods to cater to the surgical needs of a very large number of children with congenital heart defects while dealing with severe budgetary constraints, finding funding to maintain the program, and maintaining quality in the backdrop of constant turnover of trained medical, nursing, and other paramedical personnel. Choosing the best procedure to achieve maximum palliation at lower cost and, when possible, giving priority for one-stage corrective procedures, albeit at a higher risk, calls for practice modifications.

Somatic growth after ventricular septal defect in malnourished infants.

Objective: To assess somatic growth after ventricular septal defect (VSD) repair in severely malnourished infants.

Study Design: Ninety consecutive infants (age at surgery: 7.2 +/- 3.