Background Cardiac catheterization after congenital heart surgery may play an important role in the diagnosis and management of patients with a complicated or unusual post-operative course. The main objective of this study was to evaluate the safety, efficacy, and outcome of cardiac catheterization performed in the early post-operative period following congenital heart surgery. All patients who underwent cardiac catheterization after congenital heart surgery during the same admission of cardiac surgery from November 2015 to May 2018 were included in the study. Results Thirty procedures were performed for 27 patients (20 interventional and 10 diagnostic). The median age of the patients was 15 months (15 days to 20 years), median weight was 8.2 kg (3.4 to 53 kg), and median time from surgery was 3 days (0–32 days). Eleven procedures were performed for 11 patients on extracorporeal membrane oxygenation (ECMO) support. The main indications for catheterization included the inability to wean from ECMO (10 procedures) and cyanosis (10 procedures). Interventional procedures included angioplasty using stents (10 procedures, success rate of 90%), angioplasty using only balloons (2 procedures, success rate of 50%), and occlusion for residual shunts (8 procedures, success rate of 100%). No mortality was recorded during any procedure. Vasoactive–inotropic score had significantly decreased 48 h after catheterization when compared to pre-catheterization scores (p = 0.0001). Moreover, 72% of patients connected to ECMO support were successfully weaned from ECMO after catheterization. Procedural complications were recorded in 3 interventional procedures. Survival to hospital discharge was 55.5% and overall survival was 52%. Patients on ECMO support had a higher mortality than other patients. Conclusion Cardiac catheterization can be performed safely in the early post-operative period, and it could improve the outcome of the patient (depending on the complexity of the cardiac lesions involved).
In this study L-glutaminase production by extremely halotolerant Halomonas elongata MM-5 using solid-state fermentation was investigated. Screening of a variety of agro-industrial byproducts such as rice husk, green gram husk, bengal gram husk, red gram husk, safflower oil cake, groundnut oil cake, black gram husk, groundnut skin and wheat bran was carried out individually and in different combinations. Optimization of various physicochemical parameters namely incubation time, pH, temperature, initial moisture content, carbon sources, nitrogen sources, L-glutamine concentration and inoculum level was carried out. Among the various substrates screened individually red gram husk supported the maximum production of enzyme 79.03±0.49 IU/gds. In the mixture of substrates screened red gram husk and bengal gram husk in the ratio (60:40) showed maximum 92.06±1.42 IU/gds enzyme production. The L-glutaminase production was maximum after 4 days of incubation period, pH 8, temperature 40°C and 80 percent moisture content. The lactose and malt extract used as carbon and nitrogen sources respectively supported the maximum yield of L-glutaminase. After screening and optimization of various parameters, the yield of L-glutaminase increased from 79.03 to 159.12 IU/gds.
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