Indian heart journal最新文献

{"title":"Evolving spectrum and outcomes of infective endocarditis in North India: A comparative analysis between people who inject drugs and those who do not.","authors":"Keshav Sachdeva, Jasneet Kaur, Ananta Kanwar, Abhishek Goyal, Gautam Singal, Akash Batta, Anshuman Gupta, Shibba Takkar Chhabra, Naved Aslam, Gurveer Singh Raien, Pranav Ahuja, Raagini Gupta, Jasmine Arora, Vatsalya Grover, Gurpreet Singh Wander, Bishav Mohan","doi":"10.1016/j.ihj.2026.06.006","DOIUrl":"10.1016/j.ihj.2026.06.006","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) data from South Asia remain limited, particularly among people who inject drugs (PWID). North India faces a growing injection drug burden, yet comparative IE data between PWID and non-PWID populations are scarce.</p><p><strong>Methods: </strong>This retrospective cohort study with prospective long-term follow-up was conducted at a tertiary center in Ludhiana, Punjab, India. Patients meeting modified Duke criteria for definite IE (January 2017-December 2021) were compared between PWID (n = 62) and non-PWID (n = 101) groups. Multivariate logistic regression identified in-hospital mortality predictors. Five-year vital status was ascertained by telephone contact.</p><p><strong>Results: </strong>PWID were younger (29.2 ± 7.5 vs. 45.0 ± 15.4 years, p = 0.001), predominantly male (98.4% vs. 64.4%), and had higher hepatitis C co-infection (54.8% vs. 5.9%). Blood culture positivity was greater in PWID (74.2% vs. 32.7%), with MRSA predominating (41.9% vs. 14.9%) and Pseudomonas as the second commonest PWID pathogen (16.1%). Tricuspid valve involvement dominated in PWID (71%), while mitral valve predominated in non-PWID (55.4%). In-hospital mortality was 22.7% with no between-group difference (p = 0.787). Septicemia (OR 5.25), left-sided valve involvement (OR 5.59), deranged liver function (OR 3.76), and congestive heart failure (OR 3.41) independently predicted mortality; PWID status did not. Among 92 contactable patients at five-year follow-up, cumulative mortality was 56.5%, without significant between-group difference (p = 0.33).</p><p><strong>Conclusions: </strong>IE in North India affects younger patients than Western cohorts. PWID-IE in North India shows distinct features including MRSA dominance and higher culture positivity, yet in-hospital and long-term mortality remain comparable between groups. High culture-negative rates and low surgical intervention warrant attention.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical management of hypertrophic cardiomyopathy.","authors":"Mohit D Gupta, Vrinda Goel, M P Girish","doi":"10.1016/j.ihj.2026.06.005","DOIUrl":"10.1016/j.ihj.2026.06.005","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is a genetically determined myocardial disease in which symptoms are driven not simply by ventricular hypertrophy, but by a combination of dynamic left ventricular outflow tract obstruction (LVOTO), impaired diastolic filling and other factors.The therapy for HCM differs fundamentally from routine heart failure management and must be mechanism based. In obstructive HCM, the pharmacologic objective is to blunt hypercontractility, lengthen diastole, preserve loading conditions, and reduce the LVOT gradient. In non-obstructive HCM, management is focused on symptom control, heart-rate moderation, careful volume management, and treatment of arrhythmias and congestion. Non-vasodilating beta-blockers, non-dihydropyridine calcium-channel blockers, and disopyramide have constituted the foundation of medical therapy. The contemporary era has added sarcomere-directed treatment with cardiac myosin inhibitors, particularly mavacamten and aficamten, The present review provides a pragmatic algorithm for publication-level clinical use in contemporary practice.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indian society of electrocardiology position statement on improving CPR awareness in the Indian public.","authors":"Aditya Kapoor, Ajit Bhagwat, Ashish Nabar, Satyavir Yadav, B Hygriv Rao, Yash Lokhandwala, S B Gupta, Kamlesh Raut, Ketan K Mehta, Deepa Kane, Rusheek Rawal, Aniruddha Vyas, Mandar Mahavir Shah, Amit Vora, Akshay Mehta, Joy M Thomas, Arun David Arul, Nayani Makkar, Narayanan Namboodiri, Shomu Bohora, Deepak Padmanabhan, Kinjal Goyal, Sunil Sathe, Ajit Desai, Vishal Gavali, Jitendra Makkar, Nitish Naik, Ajay Naik, Rakesh Yadav, Anoop Gupta, Debabrata Roy, Jyotirmoy Pal, Mangesh Tiwaskar, Sriniwas Samavedam, Jigeeshu V Divatia","doi":"10.1016/j.ihj.2026.05.004","DOIUrl":"10.1016/j.ihj.2026.05.004","url":null,"abstract":"<p><p>Out-of-hospital cardiac arrest (OHCA) is a major public health challenge in India. Cardiopulmonary resuscitation (CPR) awareness, training, and bystander response rates remain critically low across the country.</p><p><strong>Objective: </strong>This Indian Society of Electrocardiology position statement aims to promote nationwide CPR awareness, strengthen community response to sudden cardiac arrest (SCA) and improve survival in OHCA, with measures adapted to India-specific systems of care and bystander training.</p><p><strong>Main themes: </strong>The statement highlights the SCA burden, early recognition, rapid response, barriers to community CPR training in India, dispatcher-assisted CPR, and public access defibrillation (PAD). It emphasizes school-based CPR education, corporate social responsibility partnerships, legislative support, and development of a national CPR ecosystem. Role of digital innovations, mobile applications, virtual reality, mobile CPR training units, psychological barriers and the bystander effect are emphasized.</p><p><strong>Conclusion: </strong>The position statement advocates transforming CPR from a medical skill into a societal responsibility and improve OHCA survival in India.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human-in-the-loop governance of artificial intelligence in cardiology: From ethical principles to operational paradigms.","authors":"Kamal Sharma, Praneel Sharma, Pratyusha Sharma","doi":"10.1016/j.ihj.2026.06.002","DOIUrl":"10.1016/j.ihj.2026.06.002","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is transforming cardiology across ECG interpretation, imaging, risk prediction, remote monitoring, and workflow automation. Cardiologists need governance models that preserve clinical judgment, reduce harm, and reflect Indian realities.</p><p><strong>Methods: </strong>This narrative reviews policy documents (2018-February 2026) spanning the EU AI Act, WHO, OECD, ICMR, FDA GMLP, FUTURE-AI, CHAI, Joint Commission, and MLOps frameworks, alongside medico-legal, automation-bias, fairness, and cardiology-AI implementation studies. We compared these instruments in human-in-the-loop (HITL) oversight and identify gaps in high-risk domains such as echocardiography AI, CT-FFR, cath-lab decision support, and wearable-based rhythm monitoring in India.</p><p><strong>Discussion: </strong>We propose practical HITL governance priorities for cardiology: local validation, calibrated alerting, explicit override pathways, bias surveillance, medico-legal accountability, and governance structures embedded within everyday cardiac workflows.</p><p><strong>Conclusions: </strong>Realizing meaningful human-in-the-loop oversight requires investment in governance infrastructure, workforce development, transparent performance metrics, and learning systems treating AI-related incidents as opportunities for continuous improvement.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High dose versus low dose nitroglycerin infusion in the management of hypertensive acute pulmonary edema in an emergency setting: A randomized controlled trial.","authors":"Diya Ann Varghese, Satyabrata Guru, Sadananda Barik, Anupama Behera, Saroj Kumar Sahoo","doi":"10.1016/j.ihj.2026.06.001","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.06.001","url":null,"abstract":"<p><strong>Study objective: </strong>To compare the effectiveness and safety of high-dose versus low-dose intravenous nitroglycerin for hypertensive acute pulmonary edema in the emergency department.</p><p><strong>Methods: </strong>This open-label, pragmatic, parallel randomized controlled trial was conducted in the emergency department of a tertiary care centre in Eastern India. Adults presenting with hypertensive acute pulmonary edema (systolic blood pressure >160 mm Hg or mean arterial pressure >120 mm Hg) were randomized to receive either high-dose nitroglycerin infusion (starting at 100 μg/min, titrated up to 200 μg/min) or low-dose infusion (starting at 10 μg/min, titrated up to 100 μg/min), in addition to standard care including non-invasive ventilation and diuretics. The primary outcome was attainment of predefined clinical resolution endpoints at 3 and 6 h. Secondary outcomes included time to 25% reduction in systolic blood pressure, need for endotracheal intubation, and hypotension.</p><p><strong>Results: </strong>Sixty-four patients were enrolled, with 32 assigned to each group. At 3 h, clinical resolution occurred in 28 of 32 patients (87.5%) in the high-dose group compared with 16 of 32 patients (53.3%) in the low-dose group (p = 0.003). Time to achieve a 25% reduction in systolic blood pressure was shorter in the high-dose group (p < 0.001). Two patients (6.2%) in the low-dose group required endotracheal intubation compared with none in the high-dose group. No episodes of hypotension were observed in either group.</p><p><strong>Conclusion: </strong>Among patients with hypertensive acute pulmonary edema, high-dose intravenous nitroglycerin achieved more rapid clinical resolution and blood pressure reduction than low-dose infusion, without an observed increase in adverse events.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outcomes of balloon-expandable Myval, Sapien-3, and self-expandable valves in aortic stenosis: Propensity score-matched analysis.","authors":"Ravinder Singh Rao, Govind Narayan Sharma, Kailash Chandra","doi":"10.1016/j.ihj.2026.05.002","DOIUrl":"10.1016/j.ihj.2026.05.002","url":null,"abstract":"<p><strong>Objective: </strong>Balloon-expandable (BE) Myval transcatheter heart valve (THV) series demonstrated safety and efficacy in aortic stenosis (AS) in low, intermediate/high surgical risk patients. However, there is a limited comparative data with other contemporary valves. The study aimed to compare the early clinical outcomes of next-generation BE Myval THV series with Sapien-3 THV and self-expandable (SE) valves in severe AS patients.</p><p><strong>Methods: </strong>This retrospective study included 315 AS patients who underwent transcatheter aortic valve implantation (TAVI) with BE Myval THV series (n = 108), or BE Sapien-3 THV (n = 99) or SE valves (n = 108). Propensity-matching data (86 pairs) compared the clinical and hemodynamic outcomes at 30 days.</p><p><strong>Results: </strong>No intraprocedural death/complications were reported post-TAVI. Aortic valve area was significantly improved in BE Myval THV series (0.57 ± 0.18 cm² to 2.93 ± 0.49 cm²) and SE valves (0.60 ± 0.23 cm² to 2.66 ± 0.92 cm²) cohorts from baseline to 30 days, and peak and mean aortic gradients were significantly (p < 0.0001) reduced. Permanent pacemaker implantations (PPI) requirement was 1.16% in BE Myval THV series, 4.65% in Sapien-3 THV and 10.47% in SE valves, whereas 3.49% death observed in SE valves, 2.33 % in Myval THV series and 1.19% in Sapien-3 THV at 30 days. SE valves had 13.04% moderate and severe paravalvular regurgitation (PVR), while Myval THV series and Sapien-3 THV cohort had none.</p><p><strong>Conclusion: </strong>Safety and efficacy outcomes were comparable among three cohorts, except for higher PPI rate in SE valves cohort. At 30 days, clinical outcomes showed acceptable rates of stroke and death. Valve hemodynamics were excellent, with low rate of PVR in Myval THV series cohort.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of silent brain lesions in rheumatic mitral valve disease.","authors":"Vatsal Singh, Lokesh Chaudhari, Darshan Krishnappa, Bhagya Narayan Pandit, Deepak Padmanabhan","doi":"10.1016/j.ihj.2026.05.001","DOIUrl":"10.1016/j.ihj.2026.05.001","url":null,"abstract":"<p><strong>Background: </strong>Patients with rheumatic heart disease (RHD) are at high risk of stroke. Silent brain lesions (SBL) on brain MRI represent subclinical neurological injury, but their prevalence and predictors in RHD are not well defined.</p><p><strong>Methods: </strong>We conducted a prospective, single-center study of consecutive adults with RHD and moderate-to-severe mitral valve disease. Patients with a history of stroke, hypertension, diabetes, smoking, or ventricular dysfunction were excluded. All participants underwent a standardized protocol including clinical assessment, electrocardiography, echocardiography, and 3T brain MRI.</p><p><strong>Results: </strong>Among 79 patients (mean age 44.3 ± 11.4 years, 69.6% female), SBL were present in 14 (17.7%). Most patients (81%; n = 64) had atrial fibrillation (AF). The prevalence of SBL was similar between those with AF and those in sinus rhythm (17.2% vs. 20%). There were no significant differences in age, gender, valve lesion type (stenosis vs. regurgitation), left atrial size, or the presence of LAA thrombus between patients with and without SBL. The majority of SBL (85.7%) were located in cortical regions.</p><p><strong>Conclusions: </strong>Silent brain lesions on MRI were detectable in 17.7% RHD patients with significant mitral valve disease, even in the absence of traditional stroke risk factors. We did not find any association between occurrence of these brain lesions and atrial fibrillation or left atrial enlargement. Alternative mechanisms like pro-thrombotic states or atrial cardiomyopathy may be responsible. These findings warrant further investigation into the clinical significance and management of subclinical brain injury in RHD.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of site of right coronary artery occlusion and recovery of complete heart block in acute inferior wall myocardial infarction undergoing primary angioplasty: The RECOVER-CHB study.","authors":"Parakh Gulati, Ranjit Kumar Nath, Dheerendra Kuber, Bhagya Narayan Pandit, Shivani Rao, Puneet Aggarwal","doi":"10.1016/j.ihj.2026.05.003","DOIUrl":"10.1016/j.ihj.2026.05.003","url":null,"abstract":"<p><strong>Aim: </strong>Complete heart block (CHB) complicates a significant fraction of acute inferior wall ST-elevation myocardial infarctions (IW-STEMI) and is associated with high morbidity. Relationship between right coronary artery (RCA) occlusion site and CHB recovery remains incompletely characterised in the primary percutaneous coronary intervention (PCI) era. The objective of this study was to evaluate whether the site of RCA occlusion (ostio-proximal/mid versus distal) independently predicts the rate and duration of CHB recovery following primary PCI in acute IW-STEMI.</p><p><strong>Methods: </strong>This prospective observational study enrolled 100 patients with acute IW-STEMI with CHB who underwent primary PCI at a tertiary care centre in India. Patients were divided into Group 1 (ostio-proximal/mid RCA occlusion, n = 62) and Group 2 (distal RCA occlusion, n = 38). In-hospital serial electrocardiogram monitoring was performed till recovery/permanent pacing.</p><p><strong>Results: </strong>The overall CHB recovery rate was 91%, with no significant difference between Group 1 (88.71%) and Group 2 (94.74%, p = 0.48). Median recovery time was 12 h in both groups (p = 0.21). Independent predictors of reduced recovery included wide complex escape rhythm and associated right ventricular myocardial infarction. Multivariate analysis identified wide QRS pattern, higher baseline creatinine, development of acute kidney injury and heart failure as independent factors delaying CHB recovery in this critical patient subset.</p><p><strong>Conclusion: </strong>Angiographic site of RCA occlusion does not independently predict CHB recovery after primary PCI. Prompt revascularization, metabolic status, and haemodynamic stability are key determinants of conduction recovery, supporting an expectant management strategy with serial electrocardiogram monitoring rather than early permanent pacing based solely on lesion location.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relapse in patients with non-ischemic dilated cardiomyopathy and improved ejection fraction managed with medical therapy.","authors":"Arghadip Bose, Ajay Bahl, Ankur Gupta, Saurabh Mehrotra, Dinkar Bhasin","doi":"10.1016/j.ihj.2026.04.017","DOIUrl":"10.1016/j.ihj.2026.04.017","url":null,"abstract":"<p><strong>Background: </strong>Relapse is an important problem in nonischemic dilated cardiomyopathy (DCM) patients with improved left ventricular ejection fraction (LVEF). This study aimed to determine the long-term outcomes of patients with non-ischemic dilated cardiomyopathy and improved ejection fraction and analyse the risk of relapse in patients being managed with medical therapy.</p><p><strong>Methods: </strong>This was a single-centre, retrospective, observational study of all adult patients with non-ischemic DCM enrolled in a cohort. Patients with improved LVEF defined as LVEF <40% at baseline who showed improvement of LVEF to a level ≥40% with an absolute increase in LVEF of ≥10% while on medical therapy were included and followed-up till end of study period.</p><p><strong>Results: </strong>Of the 548 patients in the non-ischemic DCM group, 131 (23.9%) had an improved LVEF. Of these, 72 (55%) patients had sustained improvement, while 59 (45%) relapsed during follow-up. In the relapsed group, 7 (11.9%) patients had discontinued drug therapy. Relapse occurred at a median duration of 57 months (range 8-224 months) after improvement of LVEF. Of the total patients who had improved LVEF, 3.8% relapsed by 1 year, 23.7% by 5 years and 37.4% by 10 years.</p><p><strong>Conclusion: </strong>In this non-ischemic DCM cohort 23.9% patients improved their LVEF. Of these, 45% relapsed. Risk of relapse persists over long-term with nearly 50% patients relapsing more than 5 years after their improvement in LVEF. Diabetes mellitus and higher left ventricular internal diameter in diastole at improvement were independent predictors of relapse.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon pulmonary valvuloplasty as a palliative strategy for late presenting adolescents and adult patients with cyanotic congenital heart disease","authors":"Amit Kumar Pandey,&nbsp;Anu Cyriac,&nbsp;Navaneetha Sasikumar,&nbsp;Raman Krishna Kumar","doi":"10.1016/j.ihj.2026.01.002","DOIUrl":"10.1016/j.ihj.2026.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Management of late presenters with cyanotic congenital heart disease (CCHD) and reduced pulmonary blood flow is challenged by multi-system derangements from longstanding hypoxia in addition to anatomic factors. Balloon pulmonary valvuloplasty (BPV) is a potentially viable palliative option for selected patients with severely stenotic pulmonary valve and are unsuitable for definitive surgical repair</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted (2002–2024, age &gt;12 years). BPV was considered for those with a significant component of valvular pulmonary stenosis (PS) on echocardiography. A strategy of stepwise dilation using progressively larger balloon sizes, andmonitoring pulmonary artery pressures between each dilation, was adapted.</div></div><div><h3>Results</h3><div>Thirty patients [TOF (n = 13), DORV/DILV (n = 7/2), single ventricle/Unbalanced AVCD (n = 3), and corrected transposition (n = 5)] with median age: 20.5 years (IQR: 14.0–26.8), weight: 49 kg (IQR: 44.1–57.7) underwent BPV. The fluoroscopy and procedure times were 17.8 min (IQR:12.7–25.7) and 71 ± 26 min (mean ± SD), respectively. The balloon-to-annulus ratio was 1.01 (0.96–1.2). Saturation improved significantly from 76.7 ± 9.6 % to 90.2 ± 4.4 %. Complications included transient arrhythmias in five patients and fatal re-perfusion pulmonary edema during repeat BPV in one. At a median follow-up of 51 months (IQR: 26.75–139.25 months), majority of patients demonstrated sustained symptomatic relief. Seven patients underwent corrective surgery, and four required repeat BPV.</div></div><div><h3>Conclusion</h3><div>In a selected subgroup of anatomically suited patients with CCHD and PS, stepwise dilatation of the pulmonary valve resulted in improved oxygenation and symptomatic relief, which was sustained on follow-up, making it an attractive low-resource option for palliation, particularly in resource constrained LMIC settings.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 3","pages":"Pages 123-127"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}