Innovative Use of Interventional Hardware in Surgical Embolectomy in Small Infants.

Surgical embolectomy for thrombosis and ischemia following femoral arterial cannulation in small infants is rare. The nonavailability of embolectomy balloons in small sizes and the small size of the native vessels pose a challenge in repair. We describe the use of a coronary angioplasty balloon for the purpose of embolectomy in a 2.

A Rare Case of Urachal Sinus.

Abnormalities in the closure of the intraembryonic portion of the allatoic lumen result in urachal abnormalities. Urachal remnant diseases are rare in adults. Malignant urachal neoplasms, like adenocarcinoma which may probably occur due to metaplasia of the transitional epithelium of the urachal remnant are very rare.

Identification of Predictable Biomarkers in Conjunction to Framingham Risk Score to Predict the Risk for Cardiovascular disease (CVD) in Non Cardiac Subjects.

Introduction: Although the cardiovascular disease (CVD) burden is rising in different countries, the morbidity and mortality rate is not reduced to much extent because of lack of application of the biomarkers for diagnosing CVD. Hence, we aimed to establish the predictable biomarkers in conjunction to framingham risk score in order to predict the risk for CVD in non cardiac patients.

Materials And Methods: Three hundred subjects were screened for the study who came for the master health checkup.

Effect of curcumin against oxidation of biomolecules by hydroxyl radicals.

Background: Among various reactive oxygen species, hydroxyl radicals have the strongest chemical activity, which can damage a wide range of essential biomolecules such as lipids, proteins, and DNA.

Objective: The objective of this study was to investigate the beneficial effects of curcumin on prevention of oxidative damage of biomolecules by hydroxyl radicals generated in in vitro by a Fenton like reaction.

Materials And Methods: We have incubated the serum, plasma and whole blood with H2O2/Cu2+/ Ascorbic acid system for 4 hours at 37 0C and observed the oxidation of biomolecules like albumin, lipids, proteins and DNA.

Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS): rationale, design, and methods.

Background: Data on patient-reported outcomes (PROs) in adults with congenital heart disease (CHD) are inconsistent and vary across the world. Better understanding of PROs and their differences across cultural and geographic barriers can best be accomplished via international studies using uniform research methods. The APPROACH-IS consortium (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study) was created for this purpose and investigates PROs in adults with CHD worldwide.

Reducing mortality and infections after congenital heart surgery in the developing world.

Background: There is little information about congenital heart surgery outcomes in developing countries. The International Quality Improvement Collaborative for Congenital Heart Surgery in Developing World Countries uses a registry and quality improvement strategies with nongovernmental organization reinforcement to reduce mortality. Registry data were used to evaluate impact.

Low frequency magnetic force augments hepatic differentiation of mesenchymal stem cells on a biomagnetic nanofibrous scaffold.

Liver tissue engineering using polymeric nanofibrous scaffold and stem cells holds great promises for treating end-stage liver failures. The aim of this study was to evaluate hepatic trans-differentiation potential of human mesenchymal stem cells (hMSCs) on a biomagnetic electrospun nanofibrous scaffold fabricated from a blend of poly-L-lactide (PLLA), collagen and fibrin-rich blood clot, under the influence of a low frequency magnetic field. The scaffold was characterized for surface properties, biochemical and biomechanical parameters and bio-magnetic behaviour.

Emergence of SFRP5 as a pleiotropic adipocytokine and its association with Wnt signaling pathways.

The widespread perception of obesity as a non-communicable disease is slowly giving way to the view of a contagious, communicable and potentially fatal condition. The downstream comorbidities associated with it are endless. Hence, the slogan "Fat To Fit" is being promoted worldwide.

Estimation of Ischemia Modified Albumin (IMA) Levels in Patients with Acute Coronary Syndrome.

Myocardial ischemia produces free radicals that catalyze a series of oxidative reactions that damage healthy tissues. The N-terminal sequence of albumin is one of the proteins modified by these highly reactive oxygen species and forms the ischemia modified albumin (IMA). This study involves investigations undertaken in different study groups to assess the levels of IMA.

Pulmonary artery banding for univentricular heart beyond the neonatal period.

Background: It is standard practice to band the pulmonary artery at 2 to 4 weeks of age in patients with univentricular hearts with increased pulmonary blood flow. The behavior of patients banded beyond the neonatal period has not been well elucidated.

Patients And Methods: This was a retrospective chart review of 32 consecutive patients (one neonate) who underwent pulmonary artery banding for functionally univentricular heart.

Prosthetic reconstruction of bicuspid pulmonary valve in tetralogy of Fallot.

Background: Various techniques have been described for preserving pulmonary valve function in tetralogy of Fallot repair. In selected substrates, the pulmonary valve can be bicuspidized and preserved using polytetrafluoroethylene pericardial membrane.

Methods: This study was a retrospective review of 20 patients aged 11 months to 31 years with tetralogy of Fallot and a bicuspid pulmonary valve (with anteroposterior cusps) who underwent intracardiac repair from August 2010 to January 2013.

Branching vertical vein with multiple sites of obstruction in supracardiac total anomalous pulmonary venous connection.

We present the case of an infant with total anomalous pulmonary venous connection and a branching vertical vein with multiple points of narrowing, draining the confluence into the innominate vein. The embryology and clinical relevance of this interesting anatomy is discussed.

16S rRNA sequencing as a diagnostic tool in the identification of culture-negative endocarditis in surgically treated patients.

Background And Aim Of The Study: Infective endocarditis (IE) is a worldwide problem, and at least one-third of cases are culture-negative despite the use of appropriate laboratory techniques.

Methods: A broad-range polymerase chain reaction (PCR) amplification was performed of the 16S rRNA gene, followed by single-strand sequencing for 26 surgically removed heart valves from patients with culture-negative endocarditis who had undergone valve repair or replacement.

Results: Two of the 26 patients were PCR-positive, and sequencing of the amplicon identified the etiological agent.

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.

Estimation of serum neopterin in patients with acute coronary syndrome.

Background: The aim of our study was to determine neopterin levels in patients with acute coronary syndrome, in which the release of various cytokines activates the cellular immune system. There is an increase in the number and activity of T-cells in unstable atherosclerotic plaques, and of type 1 helper T-cells that produce interferon γ, which in turn produces neopterin, a byproduct of the guanosine triphosphate-biopterin pathway and a marker for activated macrophages.

Methods: We studied 600 subjects consisting of healthy volunteers and patients with noncardiac chest pain, ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, or unstable angina.

Histopathological evaluation of horse serum-induced immune complex vasculitis in swine: implication to coronary artery lesions in Kawasaki disease.

Background: Immune complex (IC) vasculitis can be experimentally induced in animal models by intravenous injection of horse serum (HS), and the findings of HS-induced IC vasculitis in swine were very similar to that of Kawasaki disease (KD). The IC mechanism may be involved in the pathogenesis of vasculitis in KD. Here, we studied the two-dimensional (2D) echocardiographic and histopathological findings of acute, subacute, and healing phases of vasculitis induced by two different types of HS, and the reproducibility of IC vasculitis in swine.

Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study.

Objective: Assess platelet rich plasma (PRP) injection for rotator cuff tendinopathy (RCT).

Design: Prospective open label study with 1-year follow-up.

Methods: Participants recruited from an outpatient sports medicine clinic had clinically and magnetic resonance image (MRI)-demonstrated RCT refractory to physical therapy and corticosteroid injection.

Bilateral anomalous pulmonary venous connection to bilateral superior caval veins.

A four-year-old girl presented with superior vena cava (SVC) type of sinus venosus defect, right upper pulmonary vein draining into right SVC-right atrium junction, left upper lobe pulmonary veins draining into the lower part of persistent left SVC (LSVC), and a patent ductus arteriosus. The anomalous pulmonary venous drainage to LSVC was overlooked in the preoperative evaluation and was found intraoperatively. Warden procedure was performed for right-sided veins.

Single-stage surgical correction of combination lesions through thoracotomy.

Coarctation of the descending aorta is associated with significant cardiac lesions in up to 50% of the patients. Under such circumstances, surgical management requires consideration of the nature of the associated lesion which usually requires a median sternotomy for surgical correction. Coarctation of the aorta (COA) is, therefore, rarely associated with lesions that are amenable to surgical correction through a thoracotomy incision.

Emergence of omentin as a pleiotropic adipocytokine.

"Less is more" - this is becoming the global quote on event of alarming rise in the prevalence of obesity among all age groups. The perspective of adipose tissue as merely a fat depot has changed in recent times. Focus is now being laid on the metabolic and inflammatory functions of the adipose tissue which is modulated through adipocytokines.

Percutaneous closure of a large aortic paravalvular leak using two duct occluder devices.

A 21-year-old male presented with severe aortic paravalvular leak. He had undergone three cardiac surgeries and also had chronic kidney disease. It was decided for a trans-catheter closure owing to the risks of a fourth surgery and co-morbidity.

The curious case of a button which led to the needle.

Foreign bodies in the heart are uncommon in children. These are often removed even if asymptomatic to prevent complications like erosion, embolization, bleeding, thrombosis, and endocarditis. We report the case of a one-and-a-half-year-old child with a hypodermic needle in the heart which was found incidentally and removed successfully by surgery.

Mycotic aneurysm complicating a covered stent implanted for coarctation of the aorta in a child.

A mycotic aneurysm associated with a covered stent in the thoracic aorta of a 12-year-old child was successfully managed by excision and replacement with aortic homograft. On follow-up, there was unobstructed flow through the homograft. This case highlights the need for high index of suspicion for mycotic aneurysm and prompt surgical intervention in children with coarctation of aorta who present with features of infective endocarditis.

Transcatheter interruption of large residual flow after device closure of "Type A" patent ductus arteriosus.

We report a case of 3-year-old girl who had persistence of large residual flow following transcatheter closure of a 6 mm 'Type A' patent ductus arteriosus using a 12 × 10 mm duct occluder. Angiography revealed a large left-to-right shunt coursing through and exiting around the implanted device. Near total abolition of the residual shunt was achieved by initial implantation of an embolization coil within the duct occluder and subsequently an Amplatzer duct occluder (ADO II) adjacent to the duct occluder.

Pregnancy associated plasma protein-A (PAPP-A) as an early marker for the diagnosis of acute coronary syndrome.

Aims And Objectives: Pregnancy associated plasma protein-A (PAPP-A), a metalloproteinase plays a pivotal role in the pathogenesis of atherosclerosis. Recent studies have reported that elevated levels of PAPP-A, signal the onset of acute coronary syndrome (ACS). We, therefore, proposed to study the analytical competence of PAPP-A in patients admitted to the emergency department with chest pain and finally diagnosed as ACS.