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Departments
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Interventional Paediatric Cardiology
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Dr. K. Sivakumar
MD DCH DNB(Paediatrics) DM DNB(Cardiology)
Chief Paediatric Cardiologist & Senior
Consultant - MIOT Centre for Children’s Cardiac
Care |
The MIOT Centre
for Children’s Cardiac care is one among the very few
centres in India which provides a comprehensive cardiac care
with a vast profile of cardiac open surgeries and cardiac
interventional procedures with best possible outcome
measures. The Children’s Cardiac care centre is armed with
the best equipment, professional manpower and
nursing/paramedical staff to provide healthcare for a large
number of children with congenital and rheumatic heart
diseases.
Interventional Paediatric
Cardiology
Interventional Paediatric Cardiology provides
solutions to various congenital and rheumatic heart diseases
without surgery. In this technology, various forms of
heart diseases like heart defects – referred to as “Holes in
Heart” (ASD, VSD, PDA, etc) are corrected using minute
catheters (Catheter is a small tube that can be inserted
into a body cavity, duct or vessel ) measuring 1-4 mm. These
catheters are inserted into the blood vessels in the groin
and certain specialised occluder devices are positioned
under complete guidance from echocardiography and
fluoroscopy. Different types of these occluders,
specifically designed for each of these defects, effect
instantaneous closure of these defects and correct the
abnormality without surgery. These procedures can be done
with only a local anaesthetic injection in the groin and
hence it does not need general anaesthesia. Since there is
no blood loss during the procedure, blood transfusions are
avoided.
Advantages of Interventions over Surgery
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No Scar:
The interventional procedures through a pinhole from the
groin avoids major surgical incisions in the chest and hence
offer a cosmetic solution ( No scar or relatively less scar)
to the correction of congenital and rheumatic heart diseases
in appropriate heart defects. |
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Reduced
Hospital Stay: The procedure can be completed in few
minutes to an hour and the recovery from sedation is
earlier. The patients can be discharged from the hospital
within 1-2 days, occasionally on the same day as a Day Case
Surgery. Prolonged stay in intensive care units and hospital
wards are not needed in these procedures. |
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Quick
Recovery: The pinhole nicks in the groin heal well
without any sutures and these don’t require the conventional
wound care after surgical incisions. |
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No Pain:
There is no pain, since the procedure avoids major
incisions. |
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Near Zero or
Reduced Morbidity rate: Most important advantage of
these interventional pinhole procedures over conventional
surgeries are avoiding cardiopulmonary bypass (extra
corporeal circulation on a heart lung machine that is
required in open heart surgeries since defects cannot be
closed on a beating heart; narrowed valves cannot be opened
effectively on a beating heart with circulating blood
through it). This reduces the morbidity after the procedure. |
About MIOT Centre of Children’s Cardiac Care Team
MIOT Centre of Children’s Cardiac Care has a very
experienced team of professionals in Paediatric
Interventional Cardiology, headed by Dr K. Sivakumar who
has performed over 2000 interventions on patients with
congenital and rheumatic heart diseases. Dr K. Sivakumar
has performed a large variety of paediatric cardiac
catheter pinhole interventions in patients not only from
India, but also from countries like Sri Lanka, Pakistan,
Maldives, United Kingdom, Australia, Seychelles,
Malaysia, Africa and Middle East.
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Facilities
MIOT Hospital is equipped with the state of
the art facilities with most modern low radiation flat
panel cardiac catheterisation laboratory with rotational
angiography and subtraction angiographic abilities. This
catheterisation laboratory with experienced technicians
and nursing professionals ensures safe, precise and
successful completion of the interventional pinhole
procedures even in the smallest of the neonates - The
smallest child to have undergone a major Cardiac
Catheter Pinhole Intervention for a large PDA was a
preterm baby weighing 1.6 kg from Sri Lanka. The
department also gains support from the best echocardiographic imaging tools from the state of the
art 3-Dimensional Echocardiogram and transesophageal
probes with the latest Philips IE 33 platform. Complete
guidance of the pinhole interventional procedures is
given by these advanced infrastructures that are
available with MIOT Hospital.
Dr. K.
Sivakumar has safely performed over 2000 cardiac
catheter interventions on a wide age range of patients -
smallest patient was a 1.6 kg premature baby with large
PDA closed with an occluder device; largest was a 120 kg
morbidly obese 38 year old patient with large 40 mm ASD
occluder device. Besides his expertise in Interventional
Cardiology, Dr. K. Sivakumar has published more than 35
articles on certain unique cardiac catheter
interventions in major international indexed medical
journals of paediatric cardiology.
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Recanalization
and stenting the PDA in delayed presentation of TGA with
intact ventricular septum, |
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Catheter closure
of large ASD, |
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Safety of PDA
closures in the smallest children weighing under 6 kg, |
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Closure of
distal aortopulmonary windows, |
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Correction of
complex cardiac conditions like aortico right atrial tunnel, |
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Hybrid
correction of tetralogy with shunts, |
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Closure of large
PDA without radiographic contrast injections in patients
with renal failure, |
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Stenting the
extrinsic compression of left main coronary artery in
Eisenmenger syndrome, |
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Closure of ASD
in altered septal planes, |
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Catheter
correction of aortic pseudo aneurysms, |
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Catheter
recanalisation of acute thrombosis of BT shunts and others. |
Unique procedures done in MIOT
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Balloon
dilatation of cortriatriatum |
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Closure of
preterm PDA |
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Closure of PDA
with severe PAH |
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Large PDA with
renal failure and multiorgan failure |
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Closure of
multiple ASD |
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Perimembranous
VSD with early aortic valve prolapse |
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PDA stenting to
retrain regressed left ventricle in TGA |
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Duct dependent
pulmonary circulation – PDA stenting |
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Hybrid
procedures in operation room |
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Stage I
management of HLHS |
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ASD closure |
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VSD closure |
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PDA closure |
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AP window
closure |
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Coronary Artery
fistula |
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Pulmonary
arteriovenous malformations |
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Systemic
arteriovenous fistula |
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Balloon
pulmonary valvotomy |
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PDA stenting |
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Conduit
dilatation and stenting |
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Renal artery
stenosis |
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Balloon aortic
valvotomy |
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Balloon
dilatation/stenting of coarctation |
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Stenting of
pulmonary artery stenosis |
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Balloon
dilatation of baffles and systemic veins |
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Balloon mitral
valvotomy |
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Balloon atrial
septostomy |
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Coil closure of
aortopulmonary collaterals |
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Recanalisation
of occluded or narrowed BT shunts |
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Balloon
dilatation of unifocalised collaterals |
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Closure of
overfunctioning aortopulmonary shunts |
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Closure of
residual cardiac defects |
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Venous
collaterals after Glenn and Kawashima surgeries |
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