Publications by authors named "Valaparambil A"

Background: Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology characterized by a large vessel vasculitis involving the aorta and its branches. Myocardial involvement is extremely unusual in TA and is mostly in the form of myocarditis, ventricular hypertrophy, and ventricular dysfunction secondary to coronary ischemia. Submitral aneurysms have been reported in TA and has been attributed to the chronic inflammatory process in TA.

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Surgical aortopulmonary shunting (SAPS) and ductal stenting (DS) are the main palliations in infants with cyanotic congenital heart diseases (CHD). We aimed to study the safety and efficacy of DS and to compare it with SAPS as a palliative procedure in infants with CHD and duct-dependent pulmonary circulation. Retrospective institutional clinical data review of consecutive infants aged < 3 months who underwent DS or SAPS over 5 years.

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Background: Several randomized trials have shown the effectiveness of drug-eluting stents (DES) over bare metal stents (BMS) in terms of repeat revascularization at 1 year; however long term data in this context is conflicting.

Aim: To assess the long term clinical outcomes after coronary artery stenting with drug-eluting stents and bare metal stents.

Methods: This is a retrospective cohort study, including 100 consecutive patients with Coronary Artery Disease who underwent successful percutaneous intervention (PCI) with implantation of DES and contemporary 100 patients who underwent PCI with implantation of BMS in the years 2005 and 2006 at our center.

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Article Synopsis
  • - The study compares the effectiveness of 3D transesophageal echocardiography (TEE) versus the more commonly used 2D TEE for planning device closures of atrial septal defects (ASD) in patients.
  • - Conducted over one year with 30 mostly female patients averaging 40.5 years old, both 2D and 3D TEE were used to assess defect characteristics, revealing a strong agreement between the two methods for measuring ASD diameters.
  • - Findings indicate that sizing the device based on 3D TEE parameters is as accurate as using 2D TEE, and an equation for predicting device size based on 3D metrics was developed, showing a high correlation
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Article Synopsis
  • Dilated cardiomyopathy (DCM) is a leading cause of heart failure in children, but research on pediatric cases is limited; this study aimed to evaluate the clinical profiles and outcomes of DCM in kids.
  • Out of 233 identified cases of pediatric cardiomyopathy, 119 were diagnosed with DCM, with common presentations including dyspnea and heart failure; many patients were treated with various heart medications.
  • Over a follow-up period, 45% of patients who were tracked died, 36% recovered, and infant onset was notably linked to higher mortality and arrhythmias; the 5-year survival rate data highlighted significant outcomes related to DCM.
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Introduction: Long QT syndrome is an inherited malignant channelopathy which leads to life-threatening arrhythmia, with multiple genotypes. Jervell and Lange-Nielsen syndrome (JLNS) is an autosomal recessive subtype of this disease, characterized by congenital sensorineural deafness and a high incidence of sudden cardiac death (SCD).

Methodology: We prospectively followed up six children who underwent left cardiac sympathetic denervation (LCSD) for JLNS in view of high-risk features despite being on maximally tolerated doses of oral propranolol.

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Introduction: Although much research has been done on adult hypertrophic cardiomyopathy, data on pediatric hypertrophic cardiomyopathy is still limited.

Methods And Results: The study enrolled all patients with cardiomyopathy who presented to us between 1990 to 2020 and were younger than 18 yrs. During the thirty-year study period, we identified 233 cases of pediatric cardiomyopathy.

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Background Device closure of atrial septal defect (ASD) has emerged as a treatment modality for the past 3 decades and has changed the natural history of ASD compared to that of surgical closure. Early intervention in ASD retards the geometrical and electrical remodelling of the atrium that contributes to the development of atrial tachyarrhythmias. We studied the incidence of atrial arrhythmias in patients undergoing surgical and device closure of ASD.

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Background: Patients with STEMI are postulated to have different culprit lesion morphology compared to NSTEMI. The use of OCT in ACS can help delineate lesion morphology. The aim of this systematic review was to analyze the available data on culprit plaque morphology in ACS patients.

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Aims: The ideal pacing strategy has been the Achilles' heel for patients with congenitally corrected transposition of great arteries (ccTGA) with bradycardia. Various pacing modalities were documented in the literature. This article describes a novel pacing strategy and its feasibility in ccTGA with an intact ventricular septum.

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Background: Semi-permanent pacing (SPP) includes the placement of a permanent lead through the internal jugular vein and connection to a pulse generator on the skin outside the venous access site.

Aim: To evaluate the clinical profile and outcomes of semi-permanent pacing in a tertiary care institute in Southern India.

Methods: This is a retrospective observational study.

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A 66-year-old lady having complete AV block with narrow QRS escape had undergone left bundle branch pacing (LBB) with 4.1-F diameter 3830 Select SecureTM pacing lead (Medtronic Inc., Minneapolis, MN, USA).

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Tachycardiomyopathy is a common reversible cause of left ventricular dysfunction. Prompt diagnosis and treatment of this condition is essential to ensure a good prognosis for the patient. We report a case of tachycardiomyopathy due to frequent premature ventricular complexes arising from the right ventricular outflow tract midseptum managed with successful ablation.

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A 63-year-old gentleman presented to the emergency room (ER) with complaints of sudden onset of palpitation for the last 1 hour. He denied any presyncope or syncope. He was tachycardic with pulse rate of 120 beats per minute.

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Conduction abnormalities are commonly noted after alcohol septal ablation (ASA). This was a retrospective, observational study where we studied the incidence of new onset conduction abnormalities post ASA. 23 patients, who underwent ASA over a period of 5 years, were included in the study.

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Long term outcome data after BMS implant is not available from the Indian subcontinent. This is a prospective observational study which aims to study long term outcomes after BMS implant at a tertiary care centre. 100 consecutive patients underwent BMS implant and were followed up for 20 years.

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Ventricular tachycardia arising from the papillary muscles and other endocavitary structures are preferably ablated under intracardiac echocardiographic (ICE) guidance whenever feasible. However, the availability, need of trained operators, and the expenses involved restrict the routine use of ICE in many cath labs. Point density exclusion (PDX) mapping is a simple technique that doesn't demand any additional expense or tool apart from the routine electroanatomical mapping and thus can be widely applied in mapping of arrhythmias arising from endocavitary structures.

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Article Synopsis
  • Pocket site infection after pacemaker implantation is a serious complication that can necessitate device removal and reimplantation on the opposite side.
  • In cases where patients rely on pacing, challenges can occur if there are also issues accessing veins on the other side.
  • The report describes a patient with a pocket infection due to congenital complete heart block, who was treated with device explantation, semi-permanent pacing during antibiotics, and successful reimplantation despite subclavian vein stenosis.
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Aortic cusp prolapse is an acquired complication and usually precedes the development of aortic regurgitation (AR) in unoperated outflow ventricular septal defect (VSD). However, its impact on postoperative AR-progression is unknown. 161 patients with outflow-VSD and AR who underwent surgery between 2006 and 2012 were studied retrospectively.

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Article Synopsis
  • * Diagnostic tests, including an echocardiogram and electrophysiological study, revealed normal cardiac function and conduction pathways, with no signs of dual atrioventricular nodal physiology.
  • * Atrial pacing successfully induced the narrow QRS tachycardia, suggesting it arises from an abnormal electrical pathway in the atria, likely indicating a re-entrant circuit or automatic focus.
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Introduction: Arrhythmia arising from right ventricular outflow tract (RVOT) is the most common cause of idiopathic ventricular arrhythmia. Previous studies involving cardiac magnetic resonance imaging (MRI) in these patients are known to show abnormalities in up to 60% of patients.

Methodology: This was a retrospective descriptive analysis of patients having idiopathic RVOT arrhythmia who underwent cardiac MRI between January 2010 and December 2020.

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