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  1. Home
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Browsing by Author "Muthukumar, Siva"

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    Anaesthetic Challenges in Cardiac Interventional Procedures
    (Scientific Research, 2014-11) Thangavel, Periyasamy; Muthukumar, Siva; Karthekeyan, Baskar R.; Vakamudi, Mahesh; Nayagam, Hemananand
    The increasing scope of interventions in the cardiac catheterization laboratory (CCL) and electrophysiological laboratory (EPL) has resulted in new challenges for the anaesthesia teams where they deal with different patient categories, complications and safety issues. Collaboration and planning between cardiologist and anaesthesiologist are required for both patient safety and procedural success. This review aims to discuss procedures performed in interventional cardiology and the importance of anaesthesiologists in managing such patients. Percutaneous interventions are being increasingly performed in adult as well as in pediatric patients. Procedures are usually done under mild to moderate sedation. General anaesthesia is required in certain conditions and also in pediatric patients. Knowledge of echocardiography, individual disease condition and fluoroscopy is important. Anaesthesiologists are assuming an increasingly important role in the multidisciplinary management of complex patients and interventions. A comprehensive understanding of procedures is essential to provide a high level of anaesthetic care and maintain patient safety
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    Our Experience in 33 Patients of Multiple Ventricular Septal Defect Closure
    (Scientific Research, 2015-10) Thangavel, Periyasamy; Kamalakkannan, Ganapathy S.; Karthekeyan, Baskar R.; Muthukumar, Siva; Vakamudi, Mahesh; Rethinasamy, Jebaraj
    Study: Retrospective study of 33 patients with multiple VSD during March 2009 to March 2014. Technique: The defects were located by injecting the cardioplegia solution into left atrium after occluding the pulmonary artery. Through right atrial approach, the large ventricular septal defects were closed by pericardial patch. The smaller ventricular septal defects were closed directly. Results: Out of 33 patients, 20 patients were multiple ventricular septal defects, 5 patients were atrioventricular canal defect with multiple ventricular septal defects and 8 patients were transposition of great arteries with multiple ventricular septal defects. All the patients had severe pulmonary arterial hypertension. The mean age and body weight at repair was 4.51 months and 5.41 kg respectively. Failure to locate additional ventricular septal defects happened in 1 patient where the pulmonary artery banding was done. Six patients had residual ventricular septal defect after surgery, and no significant left to right shunted. One patient had permanent pacemaker implanted in the postoperative period due to the heart block. There was no early and late mortality. Conclusion: Management of multiple ventricular septal defects is quite complex. Right atrial approach of ventricular septal defects closure is safe, simple and effective in closure of multiple ventricular septal defects

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