Browsing by Author "Balaji, Thotakura"

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    Morphometric and Clinical Analysis of Moderator Band in Humans.
    (2015-10) RajilaRajendran, HannahSugirthabai; Victor, Ashok; Vaithianathan, Gnanasundaram; Sundaramurthi, Indumathi; Balaji, Thotakura; Yoganandham, Janani.
    Background: The moderator band has the right bundle of His within the right ventricle. It also is known to prevent the over dilatation of RV. It is important because of its involvement in RV infarcts, in differentiating RV from LV in congenital anomalies, in VPDs & VTs and in VSDs. The present literature is very much lacking in its morphometry. Materials and Methods: Moderator band was looked for in 50 hearts and only in this study did we find it in all the hearts. The length, the thickness, the distance from the tricuspid valve along with the presence of any trabeculations in the septal end or in the papillary muscle end were looked for and recorded. Results: The average length was 14.71±4.99mm, the average thickness was 4.97±1.64 mm, the average distance from the tricuspid orifice was 19.85±5.92 mm. The attachment to the anterior papillary muscle was found to be branched in 8 hearts that is having an incidence of 14% . The septal end were branched and separated as two in only two specimens. Only one specimen had branched attachments on both the apical and septal ends. Conclusion: The distance from tricuspid valve and knowledge of branching are important in corrective surgeries of the VSDs. An awareness of length and thickness helps the clinician to differentiate moderator band from the other structures, which may result in misdiagnosis during echocardiography. Its presence may in fact be of significance in preventing over distension of the heart in RV myocardial ischaemia.
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    An Unusual Presentation of Congenital Megacolon with A Rare Vascular Anomaly A Case Report
    (IMD Research Publications, 2022-06) Balaji, Thotakura; Kumar, Jyothi Ashok; Gnanasundara, Vaithianathan; Rajilarajendran, Hannah Sugirthabai
    Congenital megacolon also referred to as Hirschsprung’s disease or aganglionic megacolon is characterized by the absence of nerve plexus in the colon, it rarely affects the small intestine. Whereas acquired megacolon is a constant dilatation of the large intestine in the absence of disease but occurs due to various factors such as infections, emotional disturbances, stress, or secondary to inflammatory bowel diseases (IBD) such as ulcerative colitis, Crohn’s disease, and proctocolitis. In the present case, we report here an unusual form of megacolon. The sigmoid colon was significantly enlarged but twisting or volvulus was not detected. The ascending, transverse, and remaining part of descending colon and mesentery appeared normal, The possibility of false rotation of the gut was excluded. Interestingly, the artery supplying the left one-third of the transverse colon and descending colon originated from a branch of the middle colic artery. This anomalous artery was found to form a communication with the trunk of the inferior mesenteric artery, the Arc of Riolan, and gave branches that supplied the descending colon. The left colic artery was absent. The transverse colon showed a stricture between its right 2/3rd and left 1/3rd, confirming with vascular accidents, resulting in anomalous blood supply and aganglionosis. The dilated part of the sigmoid colon was found to be with ganglion cells, while the distal part after the megacolon, lacked ganglion cells in all layers of the sigmoid colon. This case documents a very rare finding which will make the surgeons aware of a newer arterial pattern associated with congenital megacolon.