Publications by authors named "Nishant Arora"

30 Publications

  • Page 1 of 1

Multiple Color Doppler Flow Jets Into The Atria in a Child With Heterotaxy Syndrome.

J Cardiothorac Vasc Anesth 2021 Aug 23. Epub 2021 Aug 23.

Department of Cardiothoracic surgery, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2021.08.017DOI Listing
August 2021

Analysis of the parental satisfaction for retinopathy of prematurity screening using binocular indirect ophthalmoscopy versus wide field retinal imaging.

Indian J Ophthalmol 2021 08;69(8):2142-2145

Medical Director, Dhami Eye Care Hospital, Ludhiana, Punjab, India.

Purpose: Analysis of the parental satisfaction for retinopathy of prematurity screening using binocular indirect ophthalmoscopy versus wide field retinal imaging.

Methods: This was an observational, questionnaire survey-based study. The study cohort comprised of parents/legal guardians of consecutive Asian Indian premature infants enrolled for retinopathy of prematurity screening (for infants less than 2000 gms and/or 34-weeks gestational age) using binocular indirect ophthalmoscopy (BIO) with scleral depression and b) wide field retinal imaging using the 3Nethra Neo Camera (Forus Health, India). We evaluated the retina for the presence or absence of stages of ROP and plus disease. The survey analysis used closed-ended (multiple-choice) and open-ended questions for assessing 1) parents' experience/preference among the two screening modalities namely, BIO and wide field imaging used in the study, 2) knowledge prior to ROP screening, 3) knowledge gained post ROP screening, in the outpatient ophthalmologic care unit in our hospital.

Results: Parents/legal guardians of 90 infants were included in the study. Among the 90 parents who filled in the questionnaire, 62.3% were referred by their pediatrician, 23.3% came for self check-up and 14.4% incidentally came to the hospital for complaints like ocular discharge and were screened. 93.3% parents were satisfied with either ROP screening modality in our study, with 54.4% stated a preference for retinal imaging. In the study 20% of the parents felt that retinal imaging was painful for the infant and 31.1% felt that BIO was painful for the infant.

Conclusion: Wide field imaging is increasingly becoming an effective tool and screening tool in ROP screening and helps in better understanding of the disease amongst parents.
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http://dx.doi.org/10.4103/ijo.IJO_3705_20DOI Listing
August 2021

Eccentric aortic regurgitation jet: Is it benign or needs attention?

Saudi J Anaesth 2021 Apr-Jun;15(2):242-244. Epub 2021 Apr 1.

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman.

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http://dx.doi.org/10.4103/sja.sja_1046_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191252PMC
April 2021

Anaesthetic Challenges and Transesophageal Echocardiography-Guided Perioperative Management in a Patient with Uncorrected Adult Congenital Heart Disease Presenting for Emergency Laparoscopic Hysterectomy.

Turk J Anaesthesiol Reanim 2021 Apr 24;49(2):169-174. Epub 2020 Dec 24.

Clinical Fellow in Anaesthesia, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, United Kingdom.

Anaesthetic management of a patient with adult congenital heart disease with a single ventricle physiology presenting for an emergency laparoscopic surgery is challenging. The importance of a multidisciplinary approach, astute understanding of the pathophysiology and optimisation of intraoperative hemodynamic goals cannot be overemphasised. The present report describes the anaesthetic challenges and the role of transoesophageal echocardiography in perioperative management of a patient with uncorrected tetralogy of Fallot with pulmonary atresia, who successfully underwent an emergency laparoscopic hysterectomy under general anaesthesia.
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http://dx.doi.org/10.5152/TJAR.2020.373DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098740PMC
April 2021

Determination of the Cause for Persistent Hypoxemia by Transesophageal Echocardiography After a Fontan Completion.

J Cardiothorac Vasc Anesth 2021 Oct 2;35(10):3135-3138. Epub 2021 Feb 2.

Department of Pediatric Cardiology, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2021.01.054DOI Listing
October 2021

Systolic Color Doppler Flow Into The Aorta Through The Left Main Coronary Artery: What Is The Diagnosis?

J Cardiothorac Vasc Anesth 2021 Apr 2;35(4):1244-1247. Epub 2020 Oct 2.

Department of Pediatric Cardiology, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2020.09.135DOI Listing
April 2021

The role of sinus CT in surgical treatment decisions for chronic rhinosinusitis.

Am J Otolaryngol 2020 Nov - Dec;41(6):102729. Epub 2020 Sep 12.

Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi 110001, India.

Aims & Objectives: To define a predictive role of Lund Mackay CT scan [LM] score in treatment of chronic rhinosinusitis [CRS] by functional endoscopic sinus surgery [FESS].

Materials & Methods: A prospective study was done on the cited subject in a sample size of 30 patients suffering from CRS failing maximal medical treatment. All the patients underwent FESS under general anaesthesia. CT scan with Lund Mackey scoring was done preoperatively and postoperatively. The symptomatic improvement was analysed using SNOT-22 score over a time period of one year. The SNOT-22 scores were statistically analysed with pre-op Lund Mackey scores to draw judicious conclusions.

Results: A mean Lund Mackey pre-operative score [LM] of 13.1 was recorded in the patients undergoing FESS for CRS. Further, the patients were divided into two groups: one with LM score less than 13.1 [Group-A] and the other with LM score of more than 13.1 [Group B]. A statistically significant improvement in symptoms with good long-term prognosis was recorded in Group-B only. In addition, a direct correlation between Lund Mackay score and extent of surgery was also seen, greater the score more extensive the FESS.

Conclusion: There is a predictive value of LM score in prognosis of FESS. We believe that a minimum LM score of 13.1 gives good clinical outcomes in patients with CRS who undergo FESS and thus can be used as a threshold for recruiting CRS patients for FESS.
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http://dx.doi.org/10.1016/j.amjoto.2020.102729DOI Listing
December 2020

Ultrasound-Guided Out-of-Plane Versus In-Plane Radial Artery Cannulation in Adult Cardiac Surgical Patients.

J Cardiothorac Vasc Anesth 2021 Jan 15;35(1):84-88. Epub 2020 Aug 15.

Department of Studies and Research, Oman Medical Specialty Board, Muscat, Oman.

Objectives: The primary objective was to compare the rate of first-pass radial arterial cannulation using out-of-plane ultrasound guidance with in-plane imaging. The secondary endpoints were a comparison of the number of times the cannula was redirected, the number of attempts, the number of skin punctures, the incidence of hematoma, the time to completion of the cannulation procedure, and the number of failed attempts between the 2 ultrasound imaging techniques.

Design: A prospective, randomized, observational study.

Setting: A tertiary cardiac care center.

Participants: Adult patients undergoing elective cardiac surgery.

Interventions: Radial artery cannulation with ultrasound guidance.

Measurements And Main Results: Eighty-four adult patients scheduled for elective cardiac surgery were randomly assigned to the out-of-plane ultrasound group (group I, n = 42) or the in-plane ultrasound group (group II, n = 42) for left radial artery cannulation. A linear ultrasound probe was used to identify the radial artery. In each approach, the number of times first-pass success was achieved, the number of times the cannula was redirected, the number of skin punctures, the incidence of hematomas, and the number of failed attempts were recorded. The first-pass success rate was greater in the in-plane ultrasound group and was statistically significant (p = 0.007). In the out-of-plane ultrasound group, a larger number of patients needed redirection of the cannula (p = 0.002). The number of patients in whom the skin needed to be punctured more than once was greater in the out-of-plane ultrasound group compared with the in-plane ultrasound group (p = 0.002). The incidence of hematoma formation and time to completion of the technique were similar in both groups (p = 0.241 and p = 0.792, respectively).

Conclusions: In-plane ultrasound guidance appeared to be superior for achieving a higher first-pass success rate more often with minimal redirections and skin punctures compared with out-of-plane ultrasound guidance.
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http://dx.doi.org/10.1053/j.jvca.2020.08.025DOI Listing
January 2021

A Heart Between 2 Swords.

J Cardiothorac Vasc Anesth 2021 01 3;35(1):339-342. Epub 2020 Jun 3.

Department of Pediatric Cardiology, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2020.05.037DOI Listing
January 2021

The Optimal Length of Insertion for Central Venous Catheters Via the Right Internal Jugular Vein in Pediatric Cardiac Surgical Patients.

J Cardiothorac Vasc Anesth 2020 Sep 14;34(9):2386-2391. Epub 2020 Mar 14.

Department of Studies and Research, Oman Medical Specialty Board, Muscat, Oman.

Objectives: The primary objective was to identify the best among 4 techniques that could predict the length of central venous catheter insertion through the right internal jugular vein, which, in turn, would ensure the ideal placement of the catheter tip in pediatric cardiac surgical patients. The techniques evaluated were those based on operator experience, topography/landmark methods, and one that relied on a patient's height-related formula. Based on the outcome of the study, the possibility of arriving at a formula was investigated that would predict with reasonable certainty the ideal length of catheter to be inserted for the correct catheter placement through the right internal jugular vein in pediatric cardiac surgical patients belonging to the authors' geographic area.

Design: A prospective observational study.

Setting: Tertiary care cardiac center.

Participants: Children younger than 5 years of age undergoing cardiac surgery.

Interventions: Right internal jugular vein cannulation by the Seldinger technique method.

Measurements And Main Results: A total of 120 children aged younger than 5 years undergoing cardiac surgery were included in the study. The participants were randomized to 4 groups: group 1 (n = 30), the length of the central venous catheter was determined empirically by the operator based on clinical experience; group 2 (n = 30), the depth of insertion of the catheter was determined by the distance from the site of skin puncture to the second intercostal space; group 3 (n = 30), the depth of insertion of the catheter was determined by the distance from the skin puncture site to the third intercostal space; and group 4 (n = 30), the length of catheter was determined by a height-based formula that was followed routinely at the authors' institution. Central venous catheterization through the right internal jugular vein was performed according to out-of-plane ultrasound guidance in all patients. The ideal catheter tip location was assumed to be at the level of the carina or within 1.5 cm proximal to it. The number of patients who had ideal catheter tip placement were recorded from postoperative chest radiograph in all groups. Any relationship between acceptable catheter tip and demographic data (mean ranks of age, height, weight, and body surface area) of the patients were studied.

Results: The central vein catheter tip was at the level of the carina or within 1.5 cm in more patients in group 2 (39%, p = 0.02) compared with the other groups. This was followed by group 4 (40%), group 3 (30%), and group 1 (23%). There was a statistically significant difference in the mean distance between catheter tip and carina, with group 2 patients having the tip closest to the carina (p = 0.03). There was a significant correlation between acceptable catheter tip positioning and a patient's height (p = 0.04). A new formula was developed based on this correlation.

Conclusions: A landmark-based topographic method in which the length of insertion of the catheter was determined by the distance from the skin puncture site to the second intercostal space for achieving correct placement of the catheter tip was found to be more reliable compared with other techniques. Height-based formula has the disadvantage of being affected by the skin puncture site. Assuming that a skin puncture at the midpoint between the right mastoid process and clavicular insertion of sternocleidomastoid muscle insertion is ensured, a new formula based on height has been proposed.
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http://dx.doi.org/10.1053/j.jvca.2020.03.007DOI Listing
September 2020

Temporary Apprehension Over an Artefactual Appearance of a Paraprosthetic Leak.

J Cardiothorac Vasc Anesth 2020 05 22;34(5):1391-1392. Epub 2019 Nov 22.

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2019.11.026DOI Listing
May 2020

A rare cause of wheezing in a child with pulmonary atresia.

Ann Card Anaesth 2019 Oct-Dec;22(4):449-451

Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Oman.

The determination of the exact cause for symptomatic airway obstruction in pediatric patients not responding to medication can be a clinical dilemma. Very rarely external vascular compressions can produce airway obstruction symptoms unresponsive to usual bronchodilator medications. The successful management of a child with pulmonary atresia and an innominate artery compression syndrome with respiratory compromise due to tracheal compression is described.
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http://dx.doi.org/10.4103/aca.ACA_92_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813696PMC
August 2020

Effect of low-dose dexamethasone on extra vascular lung water in patients following on-pump elective primary coronary artery bypass graft surgery.

Ann Card Anaesth 2019 Oct-Dec;22(4):372-378

Department of Studies and Research, Oman Medical Specialty Board, Muscat, Oman.

Background: The primary objective was to compare the effect of a low-dose dexamethasone as against a saline placebo on extravascular lung water index (EVLWI) in patients undergoing elective primary coronary artery bypass surgery. The secondary endpoints were to assess the effect of dexamethasone on other volumetric parameters (pulmonary vascular permeability index, global end diastolic volume index, and intrathoracic blood volume index), Vasoactive Inotrope Scores, hemodynamic parameters and serum osmolality in both groups.

Settings And Design: Prospective observational study performed at a single tertiary cardiac care center.

Materials And Methods: Twenty patients were randomized to receive either dexamethasone (steroid group, n = 10) or placebo (nonsteroid group, n = 10) twice before the institution of cardiopulmonary bypass (CPB). EVLWI and other volumetric parameters were obtained with the help of VolumeView™ Combo Kit connected to EV 1000 clinical platform at predetermined intervals. Hemodynamic parameters, vasoactive-inotropic Scores, hematocrit values were recorded at the predetermined time intervals. Baseline and 1 postoperative day serum osmolality values were also obtained.

Results: The two groups were evenly matched in terms of demographic and CPB data. Intra- and inter-group comparison of the baseline EVLWI including other volumetric and hemodynamic parameters with those recorded at subsequent intervals revealed no statistical difference and was similar. Generalized estimating equation model was obtained to compare the changes between the groups over the entire study period which showed that on an average the changes between the steroid and nonsteroid group in terms of all volumetric parameters were not statistically significant.

Conclusions: There were no beneficial effects of low-dose dexamethasone on EVLWI or other volumetric parameters in patients subjected to on-pump primary coronary bypass surgery. Hemodynamic parameters were also not affected. Probably, the advanced hemodynamic monitoring aided in optimal fluid management in the nonsteroidal group impacting EVLW accumulation.
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http://dx.doi.org/10.4103/aca.ACA_122_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813707PMC
August 2020

Intraoperative Transesophageal Echocardiography: A Sensitive and Reliable Tool for Detecting Air Embolism in Real Time.

J Cardiothorac Vasc Anesth 2019 03 20;33(3):878-880. Epub 2018 Nov 20.

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2018.11.016DOI Listing
March 2019

Interference with Innominate Artery Perfusion Due to a Transesophageal Echocardiography Probe in a Child.

J Cardiothorac Vasc Anesth 2019 01 9;33(1):256-257. Epub 2018 Oct 9.

National Heart Center Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2018.10.002DOI Listing
January 2019

Preoperative predictors of poor laryngoscope views in pediatric population undergoing cardiac catheterization.

Ann Card Anaesth 2018 Oct-Dec;21(4):376-381

Department of Studies and Research, Oman of Medical Specialty Board, Muscat, Oman.

Background: The primary objective of this study was to identify pre-anesthetic airway assessment parameters that would predict Cormack and Lehane grade III and IV laryngoscopy views in pediatric patients undergoing cardiac catheterization procedures. The secondary end points were to identify factors that would contribute to difficult laryngoscope views in this subset of patients.

Settings And Design: Prospective observational study performed at a single tertiary cardiac care center.

Materials And Methods: 199 children below 5 years of age undergoing elective cardiac catheterization were included. Pre-anesthetic airway assessment was done by modified Mallampati grading, lower lip to chin distance [LCD], tragus to mouth angle [TMA], thyromental distance [TMD], neck circumference [NC], and the ratio of height to thyromental distance [RHTMD]. Demographic data including American Society of Anesthesiologists physical status [ASA PS] were recorded for each child. Receiver Operating Characteristic curves were plotted and Areas Under the Curve were measured to identify the best cut off values for each of the airway evaluation method that would predict poor laryngoscopy views as well as assess their accuracy in doing so.

Results: LCD, TMD and low body mass index were found to have good sensitivity, specificity and accuracy in predicting Grade III and IV laryngoscope views. ASA PS grade III and above patients had a significantly higher incidence of poor laryngoscope visualization.

Conclusions: LCD, TMA, TMD, NC, RHTMD and BMI could all be used combinedly as screening tools during pre-anesthetic airway evaluation for predicting difficult laryngoscope views in children. Among these, LCD, TMD along with low body mass index might have better accuracy.
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http://dx.doi.org/10.4103/aca.ACA_47_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206807PMC
April 2019

Iatrogenic Tracheal Stenosis After Yasui Operation in a Neonate With Aortic Atresia and Type B Aortic Interruption.

J Cardiothorac Vasc Anesth 2019 May 19;33(5):1370-1374. Epub 2018 Jul 19.

Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2018.07.022DOI Listing
May 2019

Intraoperative contrast echocardiography: A valuable diagnostic tool.

J Cardiothorac Vasc Anesth 2018 12 12;32(6):e1-e2. Epub 2018 Jul 12.

Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2018.05.025DOI Listing
December 2018

Transpharyngeal Ultrasonography of Neck Vessels During Antegrade Cerebral Perfusion in a Neonate.

J Cardiothorac Vasc Anesth 2018 02 6;32(1):e27-e28. Epub 2017 Oct 6.

Department of Cardiac Anesthesia, National Heart Center Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2017.10.004DOI Listing
February 2018

Hemoptysis in a Patient With Persistent Left Upper Lobe Consolidation.

J Cardiothorac Vasc Anesth 2018 04 22;32(2):1093-1095. Epub 2017 Mar 22.

Department of Cardiology, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2017.03.024DOI Listing
April 2018

Ultrasound Guided Out-of-Plane Versus In-Plane Transpectoral Left Axillary Vein Cannulation.

J Cardiothorac Vasc Anesth 2017 Oct 15;31(5):1707-1712. Epub 2017 Feb 15.

Department of Anesthesia, Khoula Hospital, Muscat, Oman.

Objective: The primary objective was to compare the frequency of first-attempt successful axillary vein cannulation by the Seldinger technique using out-of-plane ultrasound guidance versus in-plane imaging. Between the two ultrasound imaging planes, this study also compared the number of attempts that were necessary for the cannulation of the left axillary vein along with the number of needle redirections that had to be done for final cannulation of the vein. Incidence of complications and the number of times the procedure was abandoned also were compared between the two imaging planes.

Design: Prospective, randomized, interventional study.

Setting: Tertiary care cardiac center.

Participants: Cardiac surgical patients.

Interventions: Left axillary vein cannulation under ultrasound guidance by Seldinger technique.

Measurements And Main Results: The left axillary vein was accessed under ultrasound guidance in 86 consecutive adult cardiac surgical patients. They were randomized to out-of-plane (Group I, n = 43) and in-plane (Group II, n = 43) groups. In group I, the number of first-attempt cannulations was very high (p < 0.01). The number of attempts to access the vein was significantly lower in this group (p < 0.05). The duration for completion of the procedure was also less in group I with out-of-plane ultrasound guidance (p < 0.01). The number of needle redirections and the incidence of complications (arterial puncture, pneumothorax hematoma formation) were similar between the groups. There was no difference in the number of times the procedure was abandoned between the two groups. With an assumption that the first 10 patients in each group would suffice for overcoming the learning curve, the above aspects were analyzed further in each group. The first-attempt cannulation success continued to be significantly higher in the out-of-plane group.

Conclusions: Out-of-plane ultrasound imaging during axillary vein cannulation increased the chance of first-attempt successful cannulation. Axillary vein cannulation under out-of-plane ultrasound imaging also appeared to be quicker and was preferable in terms of the fewer number of attempts that were necessary for a successful vein cannulation.
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http://dx.doi.org/10.1053/j.jvca.2017.02.011DOI Listing
October 2017

Near-Death Episode in a Young Adult.

J Cardiothorac Vasc Anesth 2017 08 11;31(4):1401-1406. Epub 2016 Oct 11.

Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman.

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http://dx.doi.org/10.1053/j.jvca.2016.10.004DOI Listing
August 2017

Transient Electromechanical Dissociation Caused by a Transesophageal Echocardiography Probe.

Ann Thorac Surg 2016 Nov;102(5):e447-e449

Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Oman.

Intraoperative transesophageal echocardiography is an established modality for confirming the preoperative diagnosis, assess adequacy of surgical repair, identify residual problems, and help improve the outcome after operation. Despite the multitude of advantages, intraoperative transesophageal echocardiography can affect the hemodynamic parameters in small neonates and children. A severe transient electromechanical dissociation caused by the anteflexion of a transesophageal echocardiography probe during a total anomalous pulmonary venous connection repair in an infant is reported.
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http://dx.doi.org/10.1016/j.athoracsur.2016.04.078DOI Listing
November 2016

Persistent Thrombocytopenia.

J Cardiothorac Vasc Anesth 2017 02 3;31(1):e17-e19. Epub 2016 Aug 3.

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2016.08.003DOI Listing
February 2017

Accidental arterial puncture during right internal jugular vein cannulation in cardiac surgical patients.

Ann Card Anaesth 2016 Oct-Dec;19(4):594-598

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman.

Background: The primary aim of this study was to compare the incidence of accidental arterial puncture during right internal jugular vein (RIJV) cannulation with and without ultrasound guidance (USG). The secondary end points were to assess if USG improves the chances of successful first pass cannulation and if BMI has an impact on incidence of arterial puncture and the number of attempts that are to be made for successful cannulation.

Settings And Design: Prospective observational study performed at a single tertiary cardiac care center.

Material And Methods: 255 consecutive adult and pediatric cardiac surgical patients were included. In Group I (n = 124) USG was used for the right internal jugular vein cannulation and in Group II (n = 81) it was not used. There were 135 adult patients and 70 pediatric patients.

Statistical Analysis: Demographic and categorical data were analyzed using Student 't' test and chi- square test was used for qualitative variables.

Results: The overall incidence of accidental arterial puncture in the entire study population was significantly higher when ultrasound guidance was not used (P< 0.001). In subgroup analysis, incidence of arterial puncture was significant in both adult (P = 0.03) and pediatric patients (P< 0.001) without USG. First attempt cannulation was more often possible in pediatric patients under USG (P = 0.03). In adult patients USG did not improve first attempt cannulation except in underweight patients.

Conclusions: USG helped in the avoidance of inadvertent arterial puncture during RIJV cannulation and simultaneously improved the chances of first attempt cannulation in pediatric and in underweight adult cardiac surgical patients.
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http://dx.doi.org/10.4103/0971-9784.191568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070317PMC
March 2017

Structural Defect Leading to an Impression of Iatrogenic Lung Damage.

J Cardiothorac Vasc Anesth 2016 Jun 3;30(3):e25-6. Epub 2015 Dec 3.

Department of Cardiac Anesthesia National Heart Center, Royal Hospital Muscat, Oman.

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http://dx.doi.org/10.1053/j.jvca.2015.12.002DOI Listing
June 2016

Induced Pectus Carinatum.

J Card Surg 2016 May 16;31(5):357-60. Epub 2016 Mar 16.

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman.

During the surgical repair of a truncus arteriosus with aortic arch interruption and pulmonary artery origin stenosis, a Contegra conduit was implanted as part of reconstruction of the pulmonary artery in a small infant. There was a mismatch between the conduit size and the patient that resulted in protrusion of the conduit between the sternal edges. To accommodate the conduit inside the thoracic cavity, traction was applied to the sternum that was gradually released over a period of time guided by transesophageal echocardiography-derived cardiac output data, as well as continuous hemodynamic parameters. doi: 10.1111/jocs.12734 (J Card Surg 2016;31:357-360).
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http://dx.doi.org/10.1111/jocs.12734DOI Listing
May 2016

Staged Single Ventricle Palliation and Homozygous Sickle Cell Disease.

J Card Surg 2016 Apr 24;31(4):237-41. Epub 2016 Feb 24.

Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Oman.

Hypoxemia is a well-known trigger for precipitating a sickling crisis in patients with sickle cell disease. Patients undergoing staged single ventricle palliation have hypoxemia during the initial stages of the Fontan pathway. The successful completion of staged single ventricle palliation in a child with a combination of homozygous sickle cell disease and a single ventricle physiology that tolerate prolonged hypoxemia during earlier stages of Fontan pathway is described.
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http://dx.doi.org/10.1111/jocs.12721DOI Listing
April 2016

A Rare Atrial Septal Malformation.

J Cardiothorac Vasc Anesth 2015 Aug 20;29(4):1100-2. Epub 2015 Feb 20.

Department of Anesthesia, Royal Hospital, Muscat, Oman. Electronic address:

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http://dx.doi.org/10.1053/j.jvca.2015.02.017DOI Listing
August 2015
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