Browsing by Author "Kulkarni, Snehal"
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Item Effect of dexmeditomidine on postoperative junctional ectopic tachycardia after complete surgical repair of tetralogy of Fallot: A prospective randomized controlled study.(2015-07) Kadam, Shankar V; Rao, Suresh G; Tailor, Kamlesh B; Kulkarni, Snehal; Mohanty, Smrutiranjan R; Joshi, Preetha V; Rao, Suresh GbIntroduction: Incidence of junctional ectopic tachycardia (JET) after repair of tetralogy of Fallot (TOF) is 5.6–14%. Dexmeditomidine is a α-2 adrenoceptor agonist modulates the release of catecholamine, resulting in bradycardia and hypotension. These effects are being explored as a therapeutic option for the prevention of perioperative tachyarrhythmia. We undertook this study to examine possible preventive effects of dexmedetomidine on postoperative JET and its impact on the duration of ventilation time and length of Intensive Care Unit stay. Methods: After obtaining approval from the hospitals ethics committee and written informed consent from parents, this quasi-randomized trial was initiated. Of 94 patients, 47 patients received dexmedetomidine (dexmedetomidine group) and 47 patients did not receive the drug (control group). Results: Dexmedetomidine group had more number of complex variants like TOF with an absent pulmonary valve or pulmonary atresia (P = 0.041). Hematocrit on cardiopulmonary bypass (CPB), heart rate while coming off from CPB and inotrope score was significantly low in the dexmedetomidine group compared to control group. The incidence of JET was significantly low in dexmedetomidine group (P = 0.040) compared to control group. Conclusions: Dexmedetomidine may have a potential benefit of preventing perioperative JET.Item Extrinsic obstruction of the main coronary arteries in a child with hypertrophic cardiomyopathy.(2002-03-28) Bandyopadhyay, Biswajit; Kulkarni, Snehal; Mody, Rohit; Cherian, K MPhasic narrowing of the coronary arteries on angiography is a well-known entity in both children and adults and has been described in relation to all epicardial arteries. There is a high incidence of myocardial bridges in hypertrophic cardiomyopathy. We report the case of a 6-year-old girl with hypertrophic obstructive cardiomyopathy who had extrinsic obstruction of the left main and right coronary arteries.Item Indian Guidelines for Indications and Timing of Intervention for Common Congenital Heart Diseases: Revised and Updated Consensus Statement of the Working Group on Management of Congenital Heart Diseases. Abridged Secondary Publication(Indian Academy of Pediatrics, 2020-02) Saxena, Anita; Jay, Relan; Agarwal, Ravi; Awasthy, Neeraj; Azad, Sushil; Chakrabarty, Manisha; Dagar, Kulbhushan S; Devagourou, Velayoudam; Dharan, Baiju S; Gupta, Saurabh K; Krishna, S Iyer; M, Jayranganath; Joshi, Raja; BRJ, Kannan; Katewa, Ashish; Kohli, Vikas; Rao, Nageswara Koneti; Kothari, Shyam S; Krishnamoorthy, KM; Kulkarni, Snehal; Kumar, Rohit Manoj; Kumar, Raman Krishna; Maheshwari, Sunita; Manohar, Krishna; Marwah, Ashutosh; Mishra, Smita; Mohanty, Smruti R; Murthy, Kona Samba; PV, Suresh; S, Radhakrishnan; Palleti, Rajashekar; Sivasubramanian, Ramakrishnan; Rao, Nitin; Rao, Suresh G; Reddy, Chinnaswamy HM; Sharma, Rajesh; Shivaprakasha, Krishnanaik; Raghavan, Subramanyan; Kumar, R Suresh; Talwar, Sachin; Tomar, Munesh; Verma, Sudeep; Vijayakumar, Rajuustification: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However,these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required whenrecommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and mayhave co-existing morbidities and malnutrition. Process: Guidelines emerged following expert deliberations at the National ConsensusMeeting on Management of Congenital Heart Diseases in India, held on 10th and 11th of August 2018 at the All India Institute of MedicalSciences, New Delhi. The meeting was supported by Children’s HeartLink, a non-governmental organization based in Minnesota, USA.Objectives: To frame evidence based guidelines for (i) indications and optimal timing of intervention in common congenital heartdiseases; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for congenital heart diseases.Recommendations: Evidence based recommendations are provided for indications and timing of intervention in common congenitalheart diseases, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductusarteriosus and others), obstructive lesions (pulmonary stenosis, aortic stenosis and coarctation of aorta) and cyanotic congenital heartdiseases (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebsteinanomaly and others). In addition, protocols for follow-up of post surgical patients are also described, disease wise.Item Outcome of Infants with Prenatally Diagnosed Congenital Heart Defects.(2015-10) Kulkarni, SnehalItem Single therapeutic catheterization for treatment of native coarctation of aorta and large patent ductus arteriosus using a covered stent.(2005-11-09) Kulkarni, Snehal; Vimala, J; Parmar, RameshA 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. This appears to be a safe strategy while dealing with an adolescent or an adult with this combination of lesions.Item Stenting stenosed aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect.(2004-05-09) Vimala, J; Kulkarni, SnehalWe 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.Item Temporary endoepicardial atrioventricular sequential pacing for complete heart block following complex surgery for congenital heart disease.(2003-01-23) Pandurangi, Ulhas M; Ruth, P J; Toal, Satish C; Kulkarni, Snehal; Murthy, K S; Cherian, K MComplete heart block following intracardiac surgical repair for complex congenital heart disease is not uncommon. In the presence of ventricular dysfunction, ventricular pacing alone may not improve the cardiac output. We report the feasibility and efficacy of endoepicardial atrioventricular sequential pacing in a case of postoperative complete heart block.