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30 results on '"Oswal, Nilesh"'

1. Transcatheter Pulmonary Valvulation

Author

Trivedi, Kalyani R., Oswal, Nilesh, Fraisse, Alain, Lacour-Gayet, Francois, editor, Bove, Edward L., editor, Hraška, Viktor, editor, Morell, Victor O., editor, and Spray, Thomas L., editor

Published
2016
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7. A rare cause of ischemic heart failure in a neonate.

Author

AlAwadhi, Zainab, Abraham, Deepu, Oswal, Nilesh, and Kasem, Mohamed

Subjects
ECHOCARDIOGRAPHY, FISTULA, MYOCARDIAL ischemia, NEONATAL diseases, CORONARY angiography, CORONARY artery abnormalities, COMPUTED tomography, HEART failure, DISEASE complications
Abstract

Herein, we present a case of ischemic heart failure that occurred immediately after birth in a neonate due to coronary artery fistula (CAF) from the left main coronary artery to the left atrial appendage associated with high pulmonary artery pressure. Ischemic heart failure in a neonate with a structurally normal heart is rare. Furthermore, CAF resulting in ischemic heart failure is very rare in neonates. We believe that the small CAF caused symptoms during the first few days of life due to moderate pulmonary hypertension which resulted in a low cardiac output. The coronary perfusion improved after the normalization of the pulmonary blood pressure and improvement of the cardiac output. Echocardiography is helpful when a CAF is suspected and can be confirmed using a cardiac computed tomography scan. Small CAFs are unlikely to cause symptoms in infants, provided there are no other factors affecting the cardiac output status. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Outcomes and re-interventions after one-stage repair of transposition of great arteries and aortic arch obstruction

Author

Huber, Christoph, Mimic, Branko, Oswal, Nilesh, Sullivan, Ian, Kostolny, Martin, Elliott, Martin, de Leval, Marc, Tsang, Victor, Huber, Christoph, Mimic, Branko, Oswal, Nilesh, Sullivan, Ian, Kostolny, Martin, Elliott, Martin, de Leval, Marc, and Tsang, Victor

Abstract

Objectives: One-stage repair of transposition of great arteries (TGA) and aortic arch obstruction (AAO) is currently advocated, but carries formidable surgical challenges. This report presents our experience and re-interventions for residual lesions over the last 10 years. Methods: Twenty-two patients (19.5±42.4 days; range 2-206; median 10 days, 3.5±0.6kg) diagnosed with TGA (nine patients) or double outlet right ventricle (DORV) (13 patients) and AAO underwent one-stage repair. Of the nine TGA patients (two with intact ventricular septum), AAO were: two patients hypoplastic arch, one patient discrete coarctation, four patients hypoplastic arch with coarctation and two patients interrupted aortic arch. The 13 DORV patients were all of Taussig-Bing type and one showed multiple ventricular septal defects (VSDs). The degree of AAO ranged from hypoplastic arch in five patients, coarctation two patients, combined four patients and interrupted aortic arch (IAA) two patients. Arterial switch with Lecomte±VSD repair was performed during cooling, and aortic arch repair was performed under deep hypothermic circulatory arrest (DHCA) (35±14min at 16.9±0.7°C). Our preference was to use homograft patch-plasty for arch and direct end-to-side anastomosis for coarctation repair. Aortic-cross-clamp time was 124±24min and cardiopulmonary bypass (CPB) time 215±84min. Results: Early survival was 19/22 (86%) up to 30 days without mortality in the second half of our series. Three patients required extracorporeal membrane oxygenation (ECMO) support and renal support was needed in three and preferred permanent pace maker (PPM) implantation in two. Length of stay was 21.9±22.1 days. There was one late death and overall survival was 18/22 (82%) for the follow-up period of 4.8 years (0.2-9.8 years). Eight patients (44%) required re-intervention for re-coarctation. Four patients required right ventricular outflow tract (RVOT)/pulmonary artery re-interventions. At follow-up, there was no requir

Published
2017

23. Neither age at repair nor previous palliation affects outcome in tetralogy of Fallot repair†.

Author

Mimic, Branko, Brown, Kate L., Oswal, Nilesh, Simmonds, Jacob, Hsia, Tain-Yen, Tsang, Victor T., De Leval, Marc R., and Kostolny, Martin

Subjects
TETRALOGY of Fallot, PALLIATIVE treatment, SURGICAL complications, REOPERATION, HEALTH outcome assessment, RETROSPECTIVE studies, THERAPEUTICS
Abstract

OBJECTIVES The study aimed to evaluate the results following complete repair of tetralogy of Fallot (TOF) in relation to age at surgery and to assess the role of palliation in the current era. METHODS A retrospective review of 251 consecutive patients with TOF repaired between 2003 and 2011 at the Great Ormond Street Hospital was performed. Children were divided into two groups: Group A, younger than 6 months (n = 78) and B, older than 6 months (n = 173). Early clinical outcomes and reoperation/reintervention rates were studied as well as indication for a palliation. RESULTS There was 1 (0.4%) early and 1 (0.4%) late death after a median follow-up time of 4.5 years. Forty-three patients (17%) underwent repair after initial palliation with inter-stage mortality of 5%. Groups A and B were similar in terms of surgical approach, postoperative complications and length of stay. Significant differences were found in terms of more frequent use of a transannular patch (P = 0.05), longer surgeries (P = 0.02) and a greater proportion of palliated patients (P = 0.002) in older patients. There was no difference in rates of reoperation/reintervention between groups and following both primary and staged repair. Palliated patients were more symptomatic (duct-dependent pulmonary blood flow; P < 0.01, cyanotic spells; P < 0.01), had more extracardiac/genetic anomalies (P < 0.01), coronary anomalies (P = 0.015) and significantly smaller pulmonary annulus, right pulmonary artery (RPA) and left pulmonary artery (LPA) Z-scores (P < 0.01 for all). CONCLUSION Age at complete repair was not linked to early clinical outcome or reoperation/reintervention rate. Palliative procedures postponed the timing of complete repair, but did not increase the reintervention rate. [ABSTRACT FROM PUBLISHER]

Published
2014
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25. Total anomalous systemic and pulmonary venous connection.

Author

Mishra, Amit, Sharma, Pranav, Shah, Ritesh, Oswal, Nilesh, and Rana, Yashpal

Abstract

Total anomalous systemic and pulmonary venous connection is an extremely rare congenital cardiac anomaly. We present our unique experience of managing this complex partially diagnosed cardiac anomaly in a 16-month-old boy. The systemic venous anomaly was not detected during the initial preoperative evaluation. He was doing well on follow-up, with normal pulmonary artery pressure. [ABSTRACT FROM PUBLISHER]

Published
2015
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27. Outcomes and re-interventions after one-stage repair of transposition of great arteries and aortic arch obstruction

Author

Huber, Christoph, Mimic, Branko, Oswal, Nilesh, Sullivan, Ian, Kostolny, Martin, Elliott, Martin, de Leval, Marc, Tsang, Victor, Huber, Christoph, Mimic, Branko, Oswal, Nilesh, Sullivan, Ian, Kostolny, Martin, Elliott, Martin, de Leval, Marc, and Tsang, Victor

Abstract

Objectives: One-stage repair of transposition of great arteries (TGA) and aortic arch obstruction (AAO) is currently advocated, but carries formidable surgical challenges. This report presents our experience and re-interventions for residual lesions over the last 10 years. Methods: Twenty-two patients (19.5±42.4 days; range 2-206; median 10 days, 3.5±0.6kg) diagnosed with TGA (nine patients) or double outlet right ventricle (DORV) (13 patients) and AAO underwent one-stage repair. Of the nine TGA patients (two with intact ventricular septum), AAO were: two patients hypoplastic arch, one patient discrete coarctation, four patients hypoplastic arch with coarctation and two patients interrupted aortic arch. The 13 DORV patients were all of Taussig-Bing type and one showed multiple ventricular septal defects (VSDs). The degree of AAO ranged from hypoplastic arch in five patients, coarctation two patients, combined four patients and interrupted aortic arch (IAA) two patients. Arterial switch with Lecomte±VSD repair was performed during cooling, and aortic arch repair was performed under deep hypothermic circulatory arrest (DHCA) (35±14min at 16.9±0.7°C). Our preference was to use homograft patch-plasty for arch and direct end-to-side anastomosis for coarctation repair. Aortic-cross-clamp time was 124±24min and cardiopulmonary bypass (CPB) time 215±84min. Results: Early survival was 19/22 (86%) up to 30 days without mortality in the second half of our series. Three patients required extracorporeal membrane oxygenation (ECMO) support and renal support was needed in three and preferred permanent pace maker (PPM) implantation in two. Length of stay was 21.9±22.1 days. There was one late death and overall survival was 18/22 (82%) for the follow-up period of 4.8 years (0.2-9.8 years). Eight patients (44%) required re-intervention for re-coarctation. Four patients required right ventricular outflow tract (RVOT)/pulmonary artery re-interventions. At follow-up, there was no requir

30. Transcatheter closure of left pulmonary artery to left atrium fistula in a neonate using amplatzer duct occluder I.

Author

Thakkar BM, Raval A, and Oswal N

Subjects
Angiography, Echocardiography, Fistula diagnostic imaging, Heart Atria diagnostic imaging, Heart Diseases diagnostic imaging, Humans, Infant, Newborn, Pulmonary Artery diagnostic imaging, Tomography, Spiral Computed, Treatment Outcome, Cardiac Catheterization methods, Fistula therapy, Heart Atria abnormalities, Heart Diseases therapy, Pulmonary Artery abnormalities, Septal Occluder Device
Abstract

A direct-fistula type communication between branch pulmonary artery (PA) to left atrium (LA), particularly left PA to LA, is a very rare congenital cardiopulmonary disorder. Although surgical repair is the conventional treatment, transcatheter device or coil closure is feasible in selected cases of a relatively frequent variant - right PA to LA fistula. Ours is the first case of successful transcatheter closure of a large left PA to LA fistula with Amplatzer duct occluder in a cyanotic neonate by transseptal approach.

Published
2014

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