The Madras Medical Mission is a hospital located in Chennai. The first unit of the hospital was set up in 1987. The hospital houses 300 beds including 76 intensive care beds.
Following transcatheter closure (TCC) of sinus venosus defects (SVD), concerns exist about thrombus formation over the stents. Spatial and temporal resolution of Transesophageal echocardiography (TEE) is sensitive to detect even small thrombus. Following TCC of SVD between May 2014 to August 2025, all patients were imaged for thrombus after one-month and one-year. Thrombus were classified as major (> 5 mm thickness) or minor (layered ≤5 mm). Anatomical, procedural details and post-procedural thromboprophylaxis were compared between patients with and without thrombus detection. Among 153 patients following SVD closure, surveillance imaging involved TEE, computed tomography and magnetic resonance in 137, 7 and 2 cases respectively and transthoracic echocardiography alone in 7 patients. At a median follow-up period of one-month (range 0.5–16 months), thrombus was detected in eleven (7.2
Background:Occupational radiation exposure remains a persistent and underestimated hazard in cardiac catheterization laboratories. This study evaluated the impact of post-licensure radiation safety training on adherence to radiation safety practices among interventional cardiologists. Methods:A nationwide cross-sectional survey was conducted between May 2022 and August 2023 among 753 interventional cardiologists. Radiation safety knowledge and practice were assessed across five domains - dose awareness, time, distance, shielding, and collimation - and combined into a composite Radiation Safety Score (RSS; Maximum 100). Demographic and practice-related variables were analysed, and multivariable log-linear regression was used to identify independent predictors of higher RSS. A study-specific, novel Radiation Safety Score (RSS) was developed to assess adherence to radiation safety practices and as such, it was not externally validated or tested for reliability among other cohorts. Results:Of the 753 respondents, 716 met the inclusion criteria. The median age was 44 years [IQR 37-52], and the mean catheterization laboratory experience was 11 ± 8.7 years. Two-thirds (66%) had attended at least one post-licensure radiation safety training program. The mean RSS was 56.5 ± 21.7, and only 16.3% achieved scores ≥ 75. Trained participants demonstrated significantly higher performance across all five radiation safety domains (p < 0.001 for each). In multivariable analysis, post-licensure radiation safety training independently predicted higher RSS (β = 0.216, p = 0.005), corresponding to a 24.1% higher adjusted score. Experience >10 years was also associated with superior RSS (β = 0.267, p < 0.001). Conclusion:Radiation safety practices among interventional cardiologists in India remain suboptimal. Participation in post-licensure radiation safety training is independently associated with better adherence across all major safety domains. Incorporating structured radiation safety training into cardiology conferences may help strengthen radiation safety culture and enhance long-term occupational protection.
ABSTRACT Noonan syndrome (NS) is a multisystem disorder with frequent heart defects, including hypertrophic cardiomyopathy (HCM). Left ventricular (LV) apical aneurysm is an extremely rare presentation in pediatric HCM. A 4-year-old child with NS, PTPN-11 mutation and HCM presented with progressive mid-cavity LV obstruction leading to a large LV apical aneurysm. Magnetic resonance imaging confirmed a large, wide-neck LV apical aneurysm. Surgery combined septal myectomy and patch repair of the aneurysm, resulting in uneventful recovery and significant gradient reduction. While multimodal imaging assists surgical planning, longitudinal surveillance should look for recurrences of aneurysm from the repaired segment, arrhythmia, and myocardial function.
Functional retroperitoneal paragangliomas are rare neuroendocrine tumors that typically present with catecholamine-mediated hypertension. 68Ga-DOTATATE PET/CT is widely used as a preferred functional imaging modality for the localization of pheochromocytoma and paraganglioma (PPGL), though false-negative results may occur. The coexistence of paraganglioma and human immunodeficiency virus (HIV) infection is exceptionally rare, with no prior reports of functional retroperitoneal paraganglioma in HIV-positive patients. We report a 42-year-old female living with HIV on stable antiretroviral therapy who presented with accelerated hypertension. Biochemical evaluation confirmed catecholamine excess with elevated plasma metanephrines. Contrast-enhanced CT demonstrated a 5 × 5 cm left para-aortic mass. Despite strong biochemical and anatomical evidence, 68Ga-DOTATATE PET/CT showed minimal uptake at the lesion site. Following comprehensive preoperative alpha-adrenergic blockade and multidisciplinary optimization, the patient underwent successful laparoscopic excision of the mass. Histopathology confirmed paraganglioma with insulinoma-associated protein 1 (INSM1)-positive staining. Postoperatively, blood pressure normalized, and biochemical markers showed complete resolution. The patient remained disease-free at six-month follow-up with excellent HIV virologic control. This case represents, to our knowledge, the first reported functional retroperitoneal paraganglioma in an HIV-positive patient. It underscores that DOTATATE-negative imaging should not exclude the diagnosis when biochemical and anatomical evidence is compelling. Laparoscopic resection is feasible and safe in carefully selected patients with well-controlled HIV infection, provided meticulous perioperative preparation and hemodynamic management are implemented.
Transcatheter closure of sinus venosus defects (SVD) is an emerging alternative to surgery, however, concerns remain regarding growth potential in paediatric patients treated with fixed-diameter stents. This retrospective study included individuals younger than 18 years from 12 centres. SVD closure was performed using covered stents after demonstration of right upper pulmonary vein redirection during balloon interrogation. Complete closure without significant residual flow was defined as procedural success. Major complications were those necessitating surgical intervention, whereas minor complications were managed intraprocedurally. Among 54 patients < 18 years, 17 had bilateral superior vena cava and six had a high-draining vein. The majority (37) underwent single-stent placement; others required multiple stents. Procedural success was 98.1
