Use of Indigenous Decellularized Valved Xenograft Conduit for Double-Barrel Right Ventricular Outflow Tract Reconstruction: Nine-Year Follow-Up.

Over the last two decades, numerous conduit options and implantation techniques have been described for right ventricular outflow tract (RVOT) reconstruction in the management of tetralogy of Fallot (TOF) with hypoplastic pulmonary annulus. The limited availability of homografts and the cost factor have led us to explore the use of decellularized xenografts as an alternative. Here we present a nine-year follow-up of an adult patient with TOF with hypoplastic pulmonary annulus, who underwent reconstruction of the RVOT by the double-barrel technique, using a decellularized porcine pulmonary artery xenograft valved conduit.

A Patient-Inspired Ex Vivo Liver Tissue Engineering Approach with Autologous Mesenchymal Stem Cells and Hepatogenic Serum.

Design and development of ex vivo bioengineered liver tissue substitutes intended for subsequent in vivo implantation has been considered therapeutically relevant to treat many liver diseases that require whole-organ replacement on a long-term basis. The present study focus on patient-inspired ex vivo liver tissue engineering strategy to generate hepatocyte-scaffold composite by combining bone marrow mesenchymal stem cells (BMSCs) derived from cardiac failure patients with secondary hyperbilirubinemia as primers of hepatic differentiation and hepatocyte growth factor (HGF)-enriched sera from same individuals as hepatic inducer. A biodegradable and implantable electrospun fibrous mesh of poly-l-lactic acid (PLLA) and gelatin is used as supporting matrix (average fiber diameter = 285 ± 64 nm, porosity = 81 ± 4%, and average pore size = 1.

In vitro hepatic trans-differentiation of human mesenchymal stem cells using sera from congestive/ischemic liver during cardiac failure.

Cellular therapy for end-stage liver failures using human mesenchymal stem cells (hMSCs)-derived hepatocytes is a potential alternative to liver transplantation. Hepatic trans-differentiation of hMSCs is routinely accomplished by induction with commercially available recombinant growth factors, which is of limited clinical applications. In the present study, we have evaluated the potential of sera from cardiac-failure-associated congestive/ischemic liver patients for hepatic trans-differentiation of hMSCs.

Nanofiber-reinforced myocardial tissue-construct as ventricular assist device.

Objectives: This study aimed to create a myocardial tissue construct by tissue engineering to repair, replace, and regenerate damaged cardiac tissue.

Methods And Results: Human cardiac muscles harvested from a homograft heart retrieval system were decellularized followed by coating with electrospun nanofibers to make them amenable to scaffolding. These processed cardiac tissues were nourished in modified media having ischemic cardiac tissue conditioned media in 6 separate experimental variants, and cord blood mononuclear cells were injected into 4 of them.

Effect of crude extract of Bombyx mori coccoons in hyperlipidemia and atherosclerosis.

The silkworm is the larva or caterpillar of the domesticated silkmoth, Bombyx mori and being a primary producer of silk is an economically important insect. These days the silk is emerging as a resource for solving a broad range of biological problems. The silk (Abresham) is popularly known as Abresham muqriz (muqriz means cut) in Unani medicine.

Aortic arch replacement with moderate hyperthomia and a modified 3-pump circuit.

A strategy employing moderate hypothermia for replacement of the aortic arch is proposed to avoid the complications of profound hypothermic circulatory arrest. Two patients underwent complete replacement of the aortic arch using three pumps (Figure 1a - one to perfuse the brain, one for the thoracoabdominal aorta and the third for the heart). There were no complications and the patients were extubated uneventfully.

Plasma total nitric oxide and endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphism: a study in a South Indian population.

In an analysis of the possible association of endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphism and plasma nitric oxide levels in patients with acute coronary syndrome, we investigated 106 patients with the syndrome and 100 healthy controls. Genotype was determined using the polymerase chain reaction; plasma nitric oxide levels were found using ELISA. The genotype frequencies for the a/b polymorphism in the control group were 77% for bb, 19% for ab, and 4% for aa.

Heart fatty acid binding protein (H-FABP) as a diagnostic biomarker in patients with acute coronary syndrome.

Aims And Objectives: Diagnosis of myocardial ischaemia at an early stage in the emergency department is often difficult. A recently proposed biomarker, heart fatty acid binding protein (H-FABP) has been found to appear in the circulation superior to that of cardiac troponins in the early hours of acute coronary syndrome. We proposed to evaluate the levels of H-FABP and ascertain its utility as an early biomarker for acute coronary syndrome (ACS).

Lipid profile and non-enzymic antioxidant status in patients with acute coronary syndrome in South India.

Aims And Objectives: Elevated lipid profile and reduced antioxidants accelerate the formation of atherosclerosis. Multiple lines of evidences have suggested that increased lipids and low antioxidants are the major risk factors for the incidence of acute coronary syndrome. Oxidative stress evaluation is now considered as an index for the assessment of development of coronary artery disease.

Genetic variants on apolipoprotein gene cluster influence triglycerides with a risk of coronary artery disease among Indians.

Apolipoprotein C3 and apolipoprotien A5 are proteins coded from the APOA1/C3/A4/A5 gene cluster. Sst I polymorphism on apolipoprotein C3 and -1131C polymorphism of apolipoprotien A5 are key variants involved in triglyceride metabolism and cause a significant cardio-metabolic risk. Here, we have evaluated these two variants for their roles in coronary artery disease in patients of the Indian population.

Increased serum concentrations of Soluble CD40 Ligand as a prognostic marker in patients with Acute Coronary Syndrome.

CD40-CD40L interaction plays a significant role in the pathogenesis of atherosclerosis and coronary artery disease. The clinical predictive value of Soluble CD40 Ligand (sCD40L) was evaluated in patients with Acute Coronary Syndrome (ACS) and Non-Cardiac Chest Pain (NCCP). The levels of serum soluble CD 40 ligand were measured by ELISA in 485 patients admitted to emergency care unit, of which 89 patients were diagnosed as NCCP.

Serum myeloperoxidase: a novel biomarker for evaluation of patients with acute coronary syndrome.

Objectives: Myeloperoxidase, an abundant leucocyte enzyme, is elevated in culprit lesions that have ruptured in patients with sudden cardiac injury. Multiple lines of evidence suggest an association between myeloperoxidase and inflammation and acute coronary syndrome. Myeloperoxidase has been proposed as a potent risk marker and diagnostic tool in acute coronary syndrome (ACS).

Pseudosequestration of the left lung.

Bronchovascular malformations of the lung constitute a broad spectrum of developmental disorders in which a part of the lung is perfused exclusively from the systemic arterial tree with or without tracheobronchial communication. We report the case of an infant with severe pulmonary artery hypertension whose entire left lung was supplied by collateral vessels from the celiac trunk and the left subclavian artery. The left tracheobronchial tree was normal.

Successful reoperation after 17 years in a case of endomyocardial fibrosis.

Endomyocardial fibrosis is an uncommon cause of congestive cardiac failure characterized by severe diffuse thickening of the endocardium, and the overall long-term prognosis of this disease is generally considered poor. We report a case of endomyocardial fibrosis that was initially treated by endocardial resection and mitral valve replacement, which was regularly followed-up. The patient underwent successful repair of a paravalvular leak after a period of 17 years.

Single therapeutic catheterization for treatment of native coarctation of aorta and large patent ductus arteriosus using a covered stent.

A 20-year-old girl was diagnosed to have severe coarctation of the aorta, large patent ductus arteriosus and severe pulmonary artery hypertension. She underwent single therapeutic catheterization for the treatment of native coarctation of aorta and closure of ductus arteriosus using 39 mm long Cheatham-Platinum covered stent. The procedure was done successfully under local anesthesia without any complication.

Anomalous origin of left coronary artery from pulmonary artery in adults.

Various techniques have been described for management of anomalous origin of the left coronary artery from the pulmonary artery presenting in adults. Three patients, 1 male and 2 females, aged 27-37 years, underwent transpulmonary pericardial patch closure with concomitant left internal thoracic artery anastomosis to the left anterior descending artery, under standard cardiopulmonary bypass, thus creating a two-coronary system. One patient had concomitant mitral valve repair.

Rheumatic involvement of all four cardiac valves.

Rheumatic involvement of all four heart valves is rare. A 35 year old woman presented with gradually progressive exertional dyspnoea for the preceding 10 years. On evaluation she was in atrial fibrillation with congestive heart failure.

Triple valve replacement with Carpentier-Edwards bioprostheses.

We report a unique case of triple valve replacement with porcine bioprostheses in a young woman who remained asymptomatic 15 years later. Although in atrial fibrillation, she was taking only aspirin for anticoagulation until she delivered a normal child 2 years after surgery. Surprisingly, to date, her echocardiographic findings have remained the same as those after childbirth, and all the bioprostheses were functioning well, except for tricuspid annular calcification producing mild to moderate regurgitation.

Stenting stenosed aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect.

We present two cases of pulmonary atresia with ventricular septal defect who were not suitable for corrective surgery due to absent or hypoplastic native pulmonary arteries and were quite symptomatic following shunt surgery. We dilated and stented stenosed aortopulmonary collaterals as palliative procedure with improvement in oxygen saturation, and significant symptomatic relief.