Publications by authors named "Nayem Raja"

4 Publications

  • Page 1 of 1

Mid-Term Follow-Up of Neonatal Neochordal Reconstruction of Tricuspid Valve for Perinatal Chordal Rupture Causing Severe Tricuspid Valve Regurgitation.

World J Pediatr Congenit Heart Surg 2020 09;11(5):587-594

Department of Pediatric and Congenital Heart Surgery, 78808Fortis Escorts Heart Institute, New Delhi, India.

Background: Papillary muscle rupture in the perinatal period is a rare event that leads to severe mitral or tricuspid insufficiency due to a flail leaflet. Neonatal tricuspid chordal reconstruction for this condition is rarely reported. Early recognition and treatment have the potential to be lifesaving. We present our surgical experience with five such patients, along with their midterm follow-up.

Methods: Between August 2010 and November 2012, five neonates (aged 1-30 days) underwent surgery for severe atrioventricular valve regurgitation. All neonates had severe tricuspid regurgitation due to ruptured chordae. In addition, two had moderate mitral regurgitation; one due to ruptured chordae of the posterior mitral leaflet and the other due to prolapse of the anterior mitral leaflet. All underwent emergent surgery where the ruptured chordae to the anterior tricuspid leaflet were replaced with neochordae made with (ePTFE) suture. The mitral valve was repaired in two patients.

Results: All patients survived surgery without the need for postoperative mechanical circulatory assist. Predischarge echocardiograms showed good coaptation of tricuspid and mitral leaflets with minimal regurgitation in all. At follow-up between 75 months to 102 months, four patients had excellent outcomes with less than mild tricuspid regurgitation. One child with flail tricuspid and mitral leaflets developed progressive tricuspid and mitral regurgitation requiring surgical re-repair at 20 months following the initial surgery.

Conclusion: Repair of chordal rupture of the tricuspid valve in neonates using e neo-chordae can provide acute salvage and gratifying midterm results in the management of this potentially fatal condition.
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http://dx.doi.org/10.1177/2150135120929011DOI Listing
September 2020

Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Through Limited Left Anterolateral Thoracotomy: An Alternative to Repeat Sternotomy.

World J Pediatr Congenit Heart Surg 2020 05;11(3):346-349

Department of Pediatric and Congenital Heart Surgery, Fortis Escorts Heart Institute, Okhla, New Delhi, India.

We report two patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement through a limited left anterolateral thoracotomy. We describe the technique in detail. Both patients were at risk of cardiac injury during repeat sternotomy. This approach reliably avoids the risk of cardiac injury during repeat sternotomy and appears to be safe, simple, and reproducible.
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http://dx.doi.org/10.1177/2150135120908868DOI Listing
May 2020

A rare case of late aortic pseudoaneurysm post double valve replacement.

Indian J Thorac Cardiovasc Surg 2018 Jul 16;34(3):425-428. Epub 2017 Dec 16.

Department of Cardiovascular and Thoracic Surgery, G. B Pant Institute of Postgraduate Medical Education and Research, University of Delhi, New Delhi, India.

Here, we present a case of pseudoaneurysm of the aorta, 2 years after double valve replacement (DVR) in an 18-year-old male patient presented with a pulsatile swelling over the sternum. The pseudoaneurysm of the aorta extending up to the skin 2 years after cardiac surgery is a rare condition. Most cases are asymptomatic and need emergency surgery. Here, we present the case which was successfully managed with surgery.
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http://dx.doi.org/10.1007/s12055-017-0623-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525690PMC
July 2018

Pulmonary artery-to-left atrial fistula discovered after the closure of atrial septal defect: A rare clinical scenario.

Ann Pediatr Cardiol 2018 May-Aug;11(2):211-213

Department of Cardiology, G B Pant Hospital, New Delhi, India.

A case of the right pulmonary artery-to- left atrial fistula with atrial septal defect (ASD) is presented. The fistula was detected after the patient developed desaturation following surgical closure of the ASD. It was managed with a transcatheter (trans-RPA route) closure of the fistula using a 12-mm Amplatzer ventricular septal defect closure device.
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http://dx.doi.org/10.4103/apc.APC_138_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963240PMC
June 2018
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