Publications by authors named "Devi Prasad Shetty"

12 Publications

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A novel surgical technique to address post septal myectomy ventricular septal defect.

Ann Thorac Surg 2021 Apr 24. Epub 2021 Apr 24.

Consultant Cardiothoracic Surgery, Narayana Institute of Cardiac Sciences.

Iatrogenic ventricular septal defect is a rare complication in patients undergoing septal myectomy for hypertrophic obstructive cardiomyopathy and it necessitates closure in the post-operative period. We describe a novel surgical technique for closure of the ventricular septal defect using a biventricular approach with a custom made Polytetrafluoroethylene device. Our method is easily reproducible.
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http://dx.doi.org/10.1016/j.athoracsur.2021.03.105DOI Listing
April 2021

Methemoglobinemia Unmasked by Use of Sodium Nitroprusside and Hypothermia in a Case of Chronic Thromboembolic Pulmonary Hypertension During Pulmonary Endarterectomy: A Case Report.

A A Pract 2020 Sep;14(11):e01311

Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bangalore, India.

In performing pulmonary endarterectomy (PEA) for a patient with chronic thromboembolic pulmonary hypertension (CTEPH), we encountered methemoglobinemia that was unmasked by hypothermia while on cardiopulmonary bypass (CPB). The patient on dapsone therapy for antiphospholipid antibody syndrome had developed acquired methemoglobinemia that went undiagnosed because her cyanosis was believed to be due to CTEPH and the resulting ventilation-perfusion (V/Q) mismatch. Although pharmacological triggers for methemoglobin are well known, causation by hypothermia is not described. Monitoring saturation while on CPB was challenging because of nonpulsatile blood flow but was overcome using cerebral oximetry.
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http://dx.doi.org/10.1213/XAA.0000000000001311DOI Listing
September 2020

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

Asian Cardiovasc Thorac Ann 2018 Feb 14;26(2):151-153. Epub 2017 Sep 14.

1 Department of Cardiac Surgery, Narayana Hrudayalaya Institute of Medical Sciences, 381800 St. John's Medical College Hospital , Bangalore, India.

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. Cardiac evaluation revealed severe disease of all 4 valves, necessitating surgery. Because he was in advanced heart failure and all 4 valves were suitable for repair, a quadruple-valve repair was performed.
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http://dx.doi.org/10.1177/0218492317733110DOI Listing
February 2018

Surgical repair of tricuspid valve leaflet tear following percutaneous closure of perimembranous ventricular septal defect using Amplatzer duct occluder I: Report of two cases.

Ann Pediatr Cardiol 2017 Jan-Apr;10(1):61-64

Glenmark Cardiac Centre, Mumbai, Maharashtra, India.

Tricuspid valve (TV) injury following transcatheter closure of perimembranous ventricular septal defect (PMVSD) with Amplatzer ductal occluder I (ADO I), requiring surgical repair, is rare. We report two cases of TV tear involving the anterior and septal leaflets following PMVSD closure using ADO I. In both the patients, the subvalvular apparatus remained unaffected. The patients presented with severe tricuspid regurgitation (TR) 6 weeks and 3 months following the device closure. They underwent surgical repair with patch augmentation of the TV leaflets. Postoperatively, both are asymptomatic with a mild residual TR.
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http://dx.doi.org/10.4103/0974-2069.197052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241847PMC
February 2017

A novel treatment for pulmonary hemorrhage during thromboendarterectomy surgery.

Ann Thorac Surg 2015 Mar;99(3):e77-8

Institute of Cardiac Sciences, Narayana Health City, Bangalore, India.

Injury to the pulmonary artery during thromboendarterectomy is a rare but potentially fatal complication with no reported surgical techniques to combat it. Treatment is only supportive and morbidity is high. We report the intraoperative diagnosis and surgical management of pulmonary hemorrhage in 3 patients after pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension.
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http://dx.doi.org/10.1016/j.athoracsur.2014.11.060DOI Listing
March 2015

Incidence of chronic thrombo-embolic pulmonary hypertension following acute pulmonary thrombo-embolism: an Indian perspective.

Indian J Chest Dis Allied Sci 2013 Oct-Dec;55(4):205-7

Chronic thrombo-embolic pulmonary hypertension (CTEPH) remains a severe disabling disease causing a significant amount of mortality and morbidity worldwide. The incidence and severity of this condition is quite obscure. The initial inciting event, the reason of progression, the natural history of the disease and the predictors of adverse outcomes are not yet adequately clarified. From the Indian subcontinent, data regarding this disease is limited. But with the advent of the multi-detector computed tomography, the understanding of this disease is gradually improving. As most of the available data suggests, acute pulmonary embolism (PE) as the main initial trigger leading to CTEPH, we prospectively analysed all patients being admitted in our hospital with acute PE and followed them over a period of one-and-a-half years to determine the incidence of CTEPH in this group. This is just an attempt to increase the awareness about the disease pattern and determine the rate of progression, risk factors of poor outcome, so that early detection and prompt treatment can benefit the patient care.
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April 2014

Anterior mediastinal teratoma presenting with pseudo-aneurysms of aorta.

Eur Heart J Cardiovasc Imaging 2014 Feb 1;15(2):227. Epub 2013 Sep 1.

Department of Radiology and Cardiovascular Surgery, Narayana Health, 258/A, Bommasandra Industrial area, Bommasandra, Bangalore 560099, India.

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http://dx.doi.org/10.1093/ehjci/jet164DOI Listing
February 2014

Entrapped central venous catheter after mitral valve replacement and its surgical retrieval.

Interact Cardiovasc Thorac Surg 2012 Sep 11;15(3):566-7. Epub 2012 Jun 11.

Narayana Hrudayalaya Hospitals, Bangalore, Karnataka, India.

Central venous pressure monitoring line insertion is routine prior to the conduct of cardiac surgery, and in rare instances, malposition can contribute to operative complications. We describe here how a central venous line lying in the right atrium became caught in a left atrial (LA) closure suture during a mitral valve replacement. The opening of the LA suture line is highly unsafe without cardiopulmonary bypass (CPB) because of the possibility of systemic air embolism, but by employing an ingenious method of suturing over and unravelling the continuous sutures closing the left atrium, it was possible to surgically retrieve it without the use of a CPB.
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http://dx.doi.org/10.1093/icvts/ivs245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422952PMC
September 2012

Unusual short-axis aortic valve view.

J Cardiothorac Vasc Anesth 2011 Feb 6;25(1):199-201. Epub 2010 Feb 6.

Narayana Hrudayalaya, Bangalore, India.

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http://dx.doi.org/10.1053/j.jvca.2009.12.004DOI Listing
February 2011

Telemedicine- a personal perspective.

Indian Heart J 2006 Nov-Dec;58(6):383

Chairman & Managing Director, Narayana Hrudayalaya, Bangalore.

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November 2015

Mast cell disease: surgical and anesthetic implications.

J Pediatr Hematol Oncol 2006 Jul;28(7):446-9

Department of Haematology, Christian Medical College, Bangalore, Karnataka, India.

Mast cell disease (MCD) is a clonal disorder of the mast cell and its precursor cells. Cardiac surgery in MCD is rarely described. We report an unusual case of a 14-year-old girl who was admitted for atrial septal defect closure and incidentally found to have hepatosplenomegaly with lymphadenopathy who underwent a successful open-heart surgery, after a diagnosis of MCD.
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http://dx.doi.org/10.1097/01.mph.0000212950.12856.d4DOI Listing
July 2006

Marsupialization of intramyocardial left anterior descending artery: a novel approach for easy access during revascularization.

Ann Thorac Surg 2005 Dec;80(6):2390-2

Department of Cardiovascular Surgery, Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India.

The left anterior descending (LAD) artery is the most important vessel bypassed during coronary revascularization procedures. This artery usually runs a superficial course, making it easy for localization and grafting. However, many times it takes a course deep in the myocardium or is embedded in thick epicardial fat, which results in technical challenges to the surgeon for localization and grafting. So far, many techniques are described for overcoming these problems, but all require cardiopulmonary bypass (CPB), and in fact, intramyocardial LAD is considered a relative contraindication for off-pump coronary artery bypass grafting (OPCAB). In the present era of enhanced interest in OPCAB, these techniques are not as helpful as they are for conventional CABG with CPB. Here, we describe a novel approach of marsupialization of the LAD for revascularization of intramyocardial LAD that is useful for off-pump as well as conventional revascularization procedures and makes grafting simple and reproducible.
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http://dx.doi.org/10.1016/j.athoracsur.2004.06.106DOI Listing
December 2005