Real-world evidence of BioMime sirolimus-eluting stent in obstructive coronary artery disease: the meriT-2 trial.

Background: The efficacy and safety of the ultrathin BioMime sirolimus-eluting coronary stent (SES) system in treating single or multiple native coronary lesions, in-stent restenosis, and bifurcation lesions have been evidenced at 1 year.

Aims: We sought to investigate the long-term safety and efficacy of the BioMime SES in a real-world population with obstructive coronary artery disease (CAD).

Methods: The prospective, single-arm, multicentre meriT-2 trial enrolled 250 patients from 11 sites across India.

Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial.

Objectives: To compare the difference in efficacy of closed tracheal suction system (CTSS) to open tracheal suction system (OTSS) in reducing incidence of ventilator associated pneumonia (VAP). Also to evaluate their efficacy in stabilizing cardio-respiratory parameters, reducing mortality and duration of intubation.

Methods: This study was a single centre, parallel group, open label, randomized controlled study with an equal allocation (1:1) in pediatric patients requiring mechanical ventilation.

Accuracy of TB-PCR using endobronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) samples in mediastinal granulomatous lymphadenopathy.

Introduction: Mediastinal granulomatous lymphadenopathies, such as tuberculous lymphadenitis, sarcoidosis, are frequently encountered by respiratory physicians, and their diagnosis is based on histological and microbiological tests. Endobronchial ultrasound-guided Trans bronchial needle aspiration (EBUS-TBNA) is widely used to perform mediastinal lymph node sampling. However, very limited data is available on the yield of polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) using EBUS-TBNA samples in patients with mediastinal granulomatous lymphadenopathy.

Left ventricular function and survival in ischemic cardiomyopathy: Implications for surgical ventricular restoration.

Objectives: This pilot study evaluates the association of relative wall thickness (RWT) on survival in patients with ischemic cardiomyopathy (ICM). We hypothesized that patients with preserved RWT may be better candidates for surgical ventricular restoration than those with thinner RWT.

Methods: Echocardiography was performed in 165 consecutive patients (aged 58.

Surgical ventricular restoration-meta-analysis of observational studies.

Background: Technique of surgical ventricular restoration (SVR) may impact its outcomes. Therefore, we conducted a meta-analysis of studies on SVR performed by using different techniques and studied outcomes.

Methods: Scientific databases were searched for studies on SVR.

Is programmed electrical stimulation mandatory for recognition of ventricular arrhythmogenicity in heart failure?

Ischemic cardiomyopathy often presents with advanced heart failure necessitating an intensive multidisciplinary approach to management. These patients constitute a very difficult population presenting with angina and ventricular tachyarrhythmias sometimes presenting as sudden cardiac death. In those patients presenting with spontaneous ventricular tachyarrhythmias, treatment with automated intracardiac defibrillator implantation has a significant mortality benefit.

Non-transplant Options in Advanced Heart Failure: Emergent Need for Guidelines ?

Advances in revascularization techniques along with its timeliness has significantly prolonged survival in Coronary Artery Disease. Progressive heart failure is one of the complications which persists in a large scale. The challenges of surgical revascularization in such patients with left ventricular dysfunction are daunting, necessitating short cross-clamp and cardio-pulmonary bypass times.

Redo quadruple-valve repair after Ross procedure: a viable option?

Quadruple-valve repair or replacement is associated with significant morbidity and mortality because the clinical situation of severe disease of all 4 valves implies incipient myocardial damage. We report a case of redo quadruple-valve repair in a patient with rheumatic heart disease who had undergone the Ross procedure 14 years earlier. He presented with heart failure.

Tailoring therapy for ischemic cardiomyopathy: is Laplace's law enough?

The burden of heart failure has long plagued the productive years of the population, with therapeutic advances in the timely treatment of ischemic heart disease decreasing its associated mortality. Angiotensin-converting enzyme inhibitors and β-blockers have impacted heart failure therapeutics in a revolutionary way. The importance of blockade of the renin-angiotensin system and adrenergic stimulation are fully accepted concepts that apply in young and old, symptomatic and asymptomatic, borderline low and very low Ejection Fraction (EF), left ventricular failure and biventricular failure.

Improvements in left ventricular twist mechanics following myectomy for hypertrophic cardiomyopathy with mid-ventricular obstruction.

We aimed to evaluate left ventricle twist mechanics in mid-ventricular obstructive and apical type of hypertrophic cardiomyopathy and changes induced by myectomy. We studied 3 consecutive patients by cardiac magnetic resonance preoperatively and 6 weeks after myectomy. We calculated the apical and basal rotations at the base and apex respectively.

Prevalence of ECG changes during adenosine stress and its association with perfusion defect on myocardial perfusion scintigraphy.

Objective: Myocardial perfusion scintigraphy (MPS) is a valuable, noninvasive imaging modality in the evaluation of patients with coronary artery disease. Adenosine stress may occasionally be associated with ECG changes. This study evaluated the strength of association between adenosine stress-related ECG changes and perfusion defects on Tc-MPS.

Characterization of dysfunctional remote myocardium in left ventricular anterior aneurysms and improvements following surgical ventricular restoration using cardiac magnetic resonance imaging: preliminary results.

Objectives: In patients with previous myocardial infarction, the remote uninfarcted regions, although contractile, demonstrate dysfunctional wall kinetics because of increased afterload, which improves after surgical ventricular restoration (SVR). We characterized left ventricular (LV) mean myocardial velocity (MMV) through an analysis of endocardial motion and wall thickening (WT) over the cardiac cycle using standard cardiac magnetic resonance (cMR).

Methods: LV endocardial motion and WT from cMR data in 7 heart failure (HF) patients with postinfarction antero apical aneurysm were compared against normal controls to establish a baseline for the mean myocardial velocity during phases of the cardiac cycle.

Optimization of surgical ventricular restoration by in-silico simulations.

Objective: A hypothesis on left ventricular aneurysms states that there is better preservation of contractile myocardium when the aneurysm geometry is rectangular as opposed to circular. Pre-surgical planning of surgical ventricular restoration was performed on the basis of this hypothesis.

Methods: The intraventricular patch used to exclude scarred or aneurysmal myocardium remains akinetic, hence it was used to define aneurysm geometry as circular or rectangular.

Scintigraphic scoring system for grading severity of gastro-esophageal reflux on 99mTc sulfur colloid gastro-esophageal reflux scintigraphy: A prospective study of 39 cases with pre and post treatment assessment.

Aim: The study aimed at developing a scoring system for scintigraphic grading of gastro-esophageal reflux (GER), on gastro-esophageal reflux scintigraphy (GERS) and comparison of clinical and scintigraphic scores, pre- and post-treatment.

Materials And Methods: A total of 39 cases with clinically symptomatic GER underwent 99mTc sulfur colloid GERS; scores were assigned based on the clinical and scintigraphic parameters. Post domperidone GERS was performed after completion of treatment.

Our experience with implantation of VentrAssist left ventricular assist device.

Perioperative anaesthetic management of the VentrAssist™ left ventricular assist device (LVAD) is a challenge for anaesthesiologists because patients presenting for this operation have long-standing cardiac failure and often have associated hepatic and renal impairment, which may significantly alter the pharmacokinetics of administered drugs and render the patients coagulopathic. The VentrAssist is implanted by midline sternotomy. A brief period of cardiopulmonary bypass (CPB) for apical cannulation of left ventricle is needed.

Awareness of fetal echo in Indian scenario.

Background: Fetal echocardiography is a well established sensitive tool to diagnose congenital heart disease (CHD) in utero. One of the determinants of effective utilization of fetal echocardiography is its awareness in the general population. The present hospital based study was undertaken to assess the awareness of the need for fetal echocardiography amongst Indian parents.

A simple technique for securing Gore-Tex neochordal height and knot slippage in mitral valve repair.

Polytetrafluoroethylene or Gore-Tex sutures are used for chordal replacement, and are durable but extremely slippery, a property which causes knot slippage and ineffective neochordal length. We report a modification that is simple and reproducible in preventing knot slippage and maintaining optimal neochordal length, without the use of devices or additional sutures.

Mosaic trisomy 9 presenting with congenital heart disease, facial dysmorphism and pigmentary skin lesions: intricate issues of genetic counseling.

Chromosomal mosaicism for full aneuploidy involving chromosome 9 is an uncommon chromosomal abnormality. Mosaic trisomy 9 clinical manifestations are highly variable and difficult to predict. The authors present a case of mosaic trisomy 9 with typical clinical manifestations(facial dysmorphism, various internal organ malformations and severe psychomotor retardation), pigmentary mosaic skin lesions along the lines of Blaschko and evidence of maternal uniparental disomy in skin.

Fourier phase analysis on equilibrium gated radionuclide ventriculography: Range of phase spread and cut-off limits in normal individuals.

Aim: To define the range of phase spread on equilibrium gated radionuclide ventriculography (ERNV) in normal individuals and derive the cut-off limit for the parameters to detect cardiac dyssynchrony.

Materials And Methods: ERNV was carried out in 30 individuals (age 53±23 years, 25 males and 5 females) who had no history of cardiovascular disease. They all had normal left ventricular ejection fraction (LVEF 55-70%) as determined by echocardiography, were in sinus rhythm, with normal QRS duration (≤120 msec) and normal coronary angiography.