KING EDWARD MEMORIAL HOSPITAL

Background History

Department of Cardiology

Located on the 4^th floor of the CVTC building, the Department of Cardiology, K.E.M. Hospital, was established by Dr. K. K. Datey in 1964 and is thus named after him. The department set up its cardiac catheterization laboratory in 1979 and has subsequently pioneered several procedures. It consists of a 25-bedded ICCU with 4 pediatric beds and a 45-bedded fully air-conditioned ward. This department caters to all aspects of cardiology and has a separate non-invasive laboratory offering exercise stress electrocardiography, Cardiopulmonary Exercise testing, Color Doppler echocardiography, Transesophageal echocardiography, Stress echocardiography, Strain imaging, Ambulatory Holter monitoring, Ambulatory blood pressure monitoring and Head Up Tilt testing. The cardiac catheterization laboratory performs coronary, structural, pediatric and electrophysiology procedures such as coronary angiography, PCI, balloon valvotomies, transcatheter device closure of ASD, VSD, PDA, RSOV, coronary cameral fistula, septal ablation for HOCM, single and dual chamber pacemaker implantations, ICDs, CRT-P/D, Radiofrequency catheter ablation of arrhythmias, etc. Advanced coronary physiology tests such as FFR, RFR and intravascular imaging such as IVUS and OCT are routinely performed. Recently, sophisticated procedures like transcatheter valve implantations (TAVR and TPVR) and leadless pacemaker have also been performed successfully.

We run general cardiology OPDs on Tuesdays, Wednesdays and Fridays from 8.30 am to 1.00 pm. There is a special Arrhythmia and Heart failure clinic on Monday mornings from 8.30 am to 1.00 pm & pediatric cardiology OPDs on Thursdays from 1.30 pm to 3.30 pm.

We are in our 6^th decade now and have served thousands of patients from all over India, with an OPD of more than 50,000 patients per year, more than 18,000 2D-Echo & Color Doppler per year, over 3,500 ICCU Admissions and more than 3,600 Cath Procedures annually and 100 PAMI’s done till date since January 2023. The commitment of our medical and paramedical staff towards patient and families is evident in the skilled and compassionate care delivered each day. They are dedicated in providing an exceptional healthcare experience.

Milestones

• 1^st Cardiac Catheterization in India (1960).
• 1^st Coronary Care Unit in India (1966).
• 1^st Cardiac Transplant in India (1968).
• 1^st Indian Hospital to acquire an ECG Machine.
• 1^st Balloon atrial septostomy in India.
• 1^st Balloon dilatation of cor triatriatum in the world.
• 1^st Transcatheter closure of ASD in Western India.
• 1^st TAVR in Government Hospital in Maharashtra (2020)
• 1^st TPVR in Government Hospital in Maharashtra (2022)
• 1^st TMVR in Government Hospital in Maharashtra (2023)
• 1^st MICRA DEVICE insertion in a Government Hospital in Maharashtra (2021)
• 1^st in India to successfully perform pacemaker explantation from a 4 year old child (2022)

Sections Units Branches

Intensive Coronary Care Unit

The annual admissions to the ICCU of around 4000 consists of patients with critical cardiac emergencies like acute myocardial infarction, unstable angina, decompensated heart failure, complex arrhythmias, hypertensive emergency, cardiac tamponade and post cardiac-cath monitoring

A committed team of doctors, professional nurses, and Class IV employees look after the patients in the ICCU round-the-clock. A cardiac monitoring device that supports electrocardiographic monitoring is installed & the ability to record and save online ECG tracings of patients is provided by a central monitor. Temporary pacing, defibrillation, oxygenation and invasive hemodynamic monitoring, including measurement of CVP, pulmonary capillary wedge pressure, and intra-arterial blood pressure, are all possible. The ICCU also has its own portable 2D Echo machine, which is used for cardiac screening of the admitted patients.

The 10 beds in the intermediate care are primarily used by patients who have been stabilized in the ICCU. When necessary, this also includes acute care amenities like those in the ICCU. Once stable, they are moved from the Intermediate to the ward.

Cardiology Ward

The Cardiology ward is 45 bedded fully air conditioned with separate wings for female and male patients. It takes care of stable patients either transferred from the ICCU or intermediate section, as well as those being admitted from the OPD. the ward is managed by our team of doctors, nurse professionals and helper staff.  Additionally, the ward is equipped with all the tools necessary for providing emergency care as .

Catheterization Laboratory

The department features two cardiac catheterization labs so that patients can receive cutting-edge medical care. It has all the necessary prerequisites for cardiac catheterization and emergency medical care and is well-equipped. Additionally, the Cathlab contains a separate Electrophysiology Unit with the newest tools for conducting diagnostic and therapeutic electrophysiology tests.

The number of catheterizations performed per year is around 2600, with all types of diagnostic and therapeutic catheterizations. The procedures performed are coronary angiography 1400/yr, Balloon Mitral Valvotomy 150/yr, Coronary angioplasty 500/yr, pediatric catheterizatons 200/yr among others. Primary PCI (PPCI or PAMI) has been initiated for patients who present to the EMS with acute coronary syndrome. The patient is moved right away to the cath lab for PAMI by the cardiology registrar who is stationed in the EMS. Additionally, wi-fi enabled ECG transmission is possible. To date, we have conducted more than 100 PAMIs. KEM is the major public hospital in the city of Mumbai which caters to neonatal and pediatric cardiology and various types of diagnostic and Interventional catheterizations are performed here. The pediatric interventions performed are transcatheter Device closure of the ASD, VSD, PDA, RSOV, CC fistula, Aorto pulmonary window closure, Balloon atrial septostomy, Balloon pulmonary valvotomy, Balloon aortic valvotomy, PDA coil closure, pulmonary artery stenting, aorto pulmonary collaterals closure (MAPCA). KEM also has the largest series of the PDA coil closures, Inoue balloon BPV, TCC of RSOV in the Western and Southern India.

Among coronary interventions we do ultrasonograhy (IVUS) guided angioplasty of left main and proximal LAD artery on a regular basis. We also perform rotational atherectomy for highly calcified lesions. We have successfully performed device closure of four patients presenting with post ischemic ventricular septal rupture (PIVSR) in 2016. We have recently started optical coherence tomography (OCT) guided angioplasty which has added a new dimension to patient care.

Doctors and paramedical staff are well-equipped at the catheterization lab. In the lab, there are always two Staff-nurses, four technicians, four class IV employees, and one Chief Sister in command. Three resident doctors, one junior consultant, and one senior consultant are always on duty at the lab. The lab is open from 7 AM to 8 PM, with emergency services available round-the-clock. In the event of a problem with a very low morbidity or mortality, every intervention is performed with a CVTS backup.

List of procedures undertaken:

1. Coronary

• CAG
• PCI
• Intra Vascular UltraSound
• Rota-ablation
• OCT
• IFR/FFR
• Drug Eluting Balloon
• Intra Vascular Lithotripsy
• Bifurcation PCI
• Left main PCI

2. Valvular

• Balloon Mitral Valvotomy
• Balloon Aortic Valvotomy
• Balloon Pulmonary Valvotomy
• Balloon Tricuspid Valvotomy
• TransCatheter Mitral Valve Replacement
• TransCatheter Aortic Valve Replacement
• TransCatheter Pulmonary Valve Replacement
• Valve-in-Valve Replacement

3. Structural

• Ruptured Sinus Of Valsava Device Closure
• Coronary Cameral Fistula Closure
• AV Fistula Closure
• LA Occlusion Device
• MAPCA Coiling
• Middle Aortic Syndrome Stenting
• Alcohol Septal Ablation

4. Congenital

• Atrial Septal Defect Device Closure
• Ventricular Septal Defect Device Closure
• PDA Device Closure/PDA Stenting
• Balloon Atrial Septostomy
• Balloon Coarctoplasty

5. Electrophysiology

• Simple Arrhythmias
• Complex Arrhythmias
• 3d Mapping and Ablation

6. Heart rhythm and cardiac device services
7. Pacemaker – Single/Dual Chamber
8. Automated Implantable Cardioverter Defibrillator – Single/Dual Chamber
9. Cardiac Resynchronisation Therapy with Pacemaker (CRT-P)
10. Cardiac Resynchronisation Therapy with Defibrillator (CRT-D)
11. Left Bundle Branch Pacing
12. His Bundle Pacing
13. Pacemaker Lead Extraction.

7. Peripheral stenting

• Renal/Subclavian

     8.  Diagnostic catheterization

Above list is compliant with NPPA guidelines issued on 14/2/2017.

Electrophysiology Department

The department of Cardiology of KEM has one of the best Electrophysiology (EP) set- ups in India. Both diagnostic and therapeutic studies are performed here.

The procedures consist of Radiofrequency ablation of various arrhythmias which include atrio-ventricular nodal reentrant tachycardia, WPW with overt and concealed preexcitation, Atrial tachycardia, Atrial Flutter, Idiopathic Ventricular tachycardia, Ischaemic Ventricular tachycardia , Bundle branch re-entrant tachycardia, AV nodal modualtion for atrial fibrillation and other diagnostic studies.

The work is carried out principally by faculty who have received EP training abroad & assisted by Assistant Professor & superspeciality Medical Officer resident doctors of the department. The success rate for the RF ablations here is more that 90 percent with a very low morbidity and negligible mortality.

In addition to the Electrophysiology studies there are a number of pacemaker and Intracardiac defibrillators implanted here. On an average around 100 dual chamber pacemakers and 70 single chamber pacemakers are implanted .on an average 25 intracardiac defibrillator implantation is also done per year. We also do 5-6 per year Cardiac resynchronization therapy  (CRTP & CRTD) .

Staff

Members of the Faculty

Bonded Assistant Professors : –

Residents:

ECG  & CPET Technicians:

Nursing Staff:

Cath lab technicians : –

Office staff :

Cleark cum typist

Contact – 91 22 24136051 extension 7636

Staff and Personnel

The department is well equipped with doctors and other paramedical personnel.

There is one Professor and Chief, two Associate Professors, three Assistant Professor in the faculty and two superspeciality medical officer. In addition, there are eighteen resident doctors working as a part of their Post Doctoral degree course in Cardiology, and two-three junior doctors from the department of Medicine who are posted here as part of their training in Cardiology.

The paramedical personnel include four Chief Staff Nurses, ten Junior Staff Nurses, two ECG technicians, two stress test Technicians, four cath lab technicians, two Echo technicians, ten servants and three Research technician. All the clerical work is done by one dedicated Clerk. With the addition of a second cath lab, more paramedical and support staff are expected.

Information for Physicians

The Department of Cardiology has set-up an electrophysiology program since 1995. The electrophysiology program primarily deals with abnormal cardiac rhythm & rate.

ELECTROPHYSIOLOGY PROGRAM :

1. Arrhythmia clinic
   Day : Monday
   Time : 9.00 am to 2.00 pm
   Place : CVTC Building 4th floor, Room no. 402.
2. Electrophysiological studies & Radiofrequency ablationIndications :
   1. Paroxysmal supraventricular tachycardia
   2. Wolf-Parkinson-White syndrome
   3. Atrial flutter
   4. Ventricular tachycardia
   5. Atrial fibrillation
   6. paroxysmal palpitations with no ECG documenting tachycardia
   7. unexplained syncope

   Procedure

   

   Placement of catheters in cardiac chambers

   Electorphysiological studies (EPS) are performed in the cardiac catheterization laboratory that has special equipment to record electrograms from within the heart. In the study three or more catheters (long, flexible wires 1.5 to 2.0 mm diameter) are inserted into the heart (figure 1). The X-ray equipment is used to position the catheters in the chambers of the heart. The heart rhythm is monitored on a special screen to show the electrical pathway of each beat. The patient needs to be admitted to the hospital the day before, or the morning of the EPS. Blood tests, X-rays, ECGs and echocardiogram may be required when the patient is admitted. Fasting for 6 hours is required before the EPS. All anti-arrhythmic medications may be stopped for 48 to 72 hours before the procedure. An informed consent would be taken. Pregnant patient are deferred from EPS. The procedure is performed under local anesthesia and mild sedation would generally be used. For young children, general anesthesia would be used. Through the femoral route cahteters are introduced into the cardiac chambers. Tachycardia can be started with the help of these catheters and during tachycardia electrograms recorded through these catheters are used to study the presence of accessory pathway or abnormal foci. Once the abnormal circuit is determined, a special catheter is used to deliver radiofrequency current at that spot which would eliminate the accessory pathway or extra connection and prevent tachycardia. The procedure takes anywhere from 90 minutes to 3 hours. When the procedure is finished, the catheters are removed and hemostasis achieved. The patient is advised rest for 4 to 6 hours and the next day the dressing is removed and patient discharged. Strenous physical exercise and lifting heavy weights is to be avoided for 15

   days to allow healing at the puncture sites in the groin. However the person can resume duty or job within next couple of days of the procedure. After successful ablation half a tablet of aspirin is prescribed for three months to allow endocardial healing.

   Appointment & waiting list :

   The appointment for EPS & radiofrequency ablation is given in the arrhythmia clinic after the patient is seen in detail with all the ECGs & other reports. There is a waiting period of 15 days to 1 month for this procedure. Telephonic appointments are given to out of station patients who have already sent referring physicians notes and all ECGs and reports in advance.

3. Pacemaker implantation
4. AICD implantation

Facilities, Equipments & Special services

Academics:

• 3 Year D.M. Cardiology Course (Intake – 6/year) (total -18)
• 3 Year B.P.M.T. Course (Intake – 5/year) (total – 15)

Achievements:

• First among government hospitals in Maharashtra to pioneer 24 hour PAMI project and to have successfully performed more than 100 PAMI till August 2023.
• First TAVR, TMVR and TPVR in a Government Hospital in Maharashtra.
• A U Mahajan is member of Drug Controller General of India (DCGI), Subject Expert Committee (SEC) for Cardiology, Govt. of India;
• A U Mahajan is a member of National List of Essential Medicines (NLEM) Sub-Committee, Cardiology, Govt. of India.
• Charan Lanjewar is an integral part of Anti-Ragging Committee; chairperson of the STEMI CARE PILOT project
• P. G. Kerkar continues to be on the National Executive Committee of the Cardiology Society of India and as a Chairman of Board of Studies in Superspeciality (Medicine & Allied Subjects) for Group of Post Graduate Subject from the Faculty of Medicine of the Maharashtra University of Health Sciences, Nashik.

Events:

• Every Saturday, there is a cath conference that includes a thorough discussion of intriguing clinical situations, 2D echo’s, coronary angiograms, a review of journal papers and case presentations.
• 2D Echo and TEE Workshops.
• MasterClasses–where residents are encouraged to present cases in National Forums.
• Pacemaker Troubleshooting.

Echocardiography machines : –

Four state of the art echo machines :

1. Philips Epiq-7C
2. Philips Affiniti CVX
3. Philips – CX 50 (Portable echo machine)
4. Wipro GE – Vivid IQ (Portable echo machine)

Units: There are currently 2 functional units : –

1. Dr. Ajay U. Mahajan (Dr.AUM)
2. Dr. Charan P Lanjewar (Dr.CPL)

Recent Publications

1.Angiotensin Receptor-Neprilysin Inhibitor Therapy and Cardiac Remodeling in Heart Failure: Consensus Statement from India.
Chopra HK, Wander GS, Nair T, Ponde CK, Nanda NC, Narula J, Ray S, Venugopal K, Iyengar SS, Kasliwal RR, Chandra P, Prakash S, Bansal S, Rana DS, Kerkar P et al. J Assoc Physicians India. 2023 Apr;71(4):11-12.PMID: 37355795

2.Role of Iron Therapy in Heart Failure: A Consensus Statement from India.Chopra HK, Wander GS, Nair T, Ponde CK, Nanda NC, Narula J, Ray S, Venugopal K, Kerkar P et al J Assoc Physicians India. 2023 Mar;71(3):11-12. doi: 10.5005/japi-11001-0214.PMID: 37354511

3.Position statement from the Indian Society of Gastroenterology, Cardiological Society of India, Indian Academy of Neurology and Vascular Society of India on gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy.Arora A, Kumar A, Anand AC, Kumar A, Yadav A, Bhagwat A, Mullasari AS, Satwik PN, Ramakrishna P, Kerkar P et al.Indian J Gastroenterol. 2023 Jun;42(3):332-346. doi: 10.1007/s12664-022-01324-6. Epub 2023 Jun 5.PMID: 37273146

4.Geographic differences in patients with acute myocardial infarction in the PARADISE-MI trial.Butt JH, Claggett BL, Miao ZM, Jering KS, Sim D, van der Meer P, Ntsekhe M, Amir O, Cho MC, Carrillo-Calvillo J, Núñez JE, Cadena A, Kerkar P et al .Eur J Heart Fail. 2023 Apr 11. doi: 10.1002/ejhf.2851. Online ahead of print.PMID: 37042062

5.Experts’ Consensus on Use of Long-Acting Nitroglycerine in the Management of Angina and Chronic Coronary Syndrome in India. Jc M, Chopra A, Js H, Mahajan A, Nair T, Ray S, Tr M, Pandey A, Srivastava S, Kumar YS, Navasundi G, Das DR, Abhyankar MV, Revankar S, Mate P.J Assoc Physicians India. 2022 Mar;70(3):11-12.PMID: 35438293

6.30-Day and 1-Year Outcomes With HYDRA Self-Expanding Transcatheter Aortic Valve: The Hydra CE Study. Aidietis A, Srimahachota S, Dabrowski M, Bilkis V, Buddhari W, Cheung GSH, Nair RK,  Mahajan AU et al.JACC Cardiovasc Interv. 2022 Jan 10;15(1):93-104. doi: 10.1016/j.jcin.2021.09.004.PMID: 34991828

7.Resolution of aortic regurgitation due to Venturi effect after device closure of ruptured sinus of Valsalva aneurysm. Kumar D, Kesavan V, Lanjewar CP, Sabnis G.Catheter Cardiovasc Interv. 2023 Jun 21. doi: 10.1002/ccd.30746. Online ahead of print.PMID: 37343041

8.Takayasu aortoarteritis masquerading left ventricular noncompaction syndrome. Gokhale Y, Patankar AS, Mahajan AU, Firke V. Journal of Indian College of Cardiology. 2022 Jan 1;12(1):40.Vaideeswar P, Sabnis G, Lanjewar C, Kundu S. Acute Aortic Dissection. InTropical Cardiovascular Pathology 2022 (pp. 327-331). Springer, Singapore.

9.Left ventricular global longitudinal strain imaging in identifying subclinical myocardial dysfunction among covid-19 survivors. Kujur PP, Jhala M, Bhondve A, Lanjewar C, Matta R, Deshmukh H. Indian Heart Journal. 2022 Jan 1;74(1):51-5.

10.Bempedoic Acid for Management of Dyslipidemia from an Indian Perspective: An Expert Consensus Report Maddury SR, Sawhney J, Kerkar PG, Jain P, Chandra P, Sashikant T, Shah J, Makkar JS, Benjamin B, Daniel R, Solanki D.. American Heart Journal. 2022 Dec 1;254:264.

11.Suspecting and diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM) in India: An Indian expert consensus Mohan JC, Dalal J, Chopra VK, Narasimhan C, Kerkar P, Oomman A, Fcsi SR, Sharma AR, Dougall P, Simon S, Drm AV.. Indian Heart Journal. 2022 Nov 21.

12.Geographic Differences Among Patients With Acute Myocardial Infarction in the PARADISE-MI Trial Butt JH, Sim D, Claggett B, Jering K, Kerkar P et al.. Circulation. 2022 Nov 8;146(Suppl_1):A14610.

13.Suspecting and diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM) in India: An Indian expert consensus. Chander Mohan J, Dalal J, Chopra VK, Narasimhan C, Kerkar P et al.Indian Heart J. 2022 Nov-Dec;74(6):441-449. doi: 10.1016/j.ihj.2022.11.006. Epub 2022 Nov 21.PMID: 36410415

14.Therapeutic adherence in hypertension: Current evidence and expert opinion from India. Dalal JJ, Kerkar P, Guha S, Dasbiswas A, Sawhney JPS, Natarajan S, Maddury SR, Kumar AS, Chandra N, Suryaprakash G, Thomas JM, Juvale NI, Sathe S, Khan A, Bansal S, Kumar V, Reddi R.Indian Heart J. 2021 Nov-Dec;73(6):667-673. doi: 10.1016/j.ihj.2021.09.003. Epub 2021 Sep 15.PMID: 34861979

15.Parenteral Iron Therapy in Patients with Heart Failure in a Resource Constrained Setting In India – Our Experience. Jhala MD, Lanjewar C, Pawar A, Shah H, Kumar D, Kerkar P.J Assoc Physicians India. 2021 Oct;69(10):11-12.PMID: 34781652

16.Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic. Zachariah G, Ramakrishnan S, Das MK, Jabir A, Jayagopal PB, Venugopal K, Mani K, Khan AK, Malviya A, Gupta A, Goyal A, N, Naik N, Hasija PK, Kerkar P et al ; CSI-AMI Study group.Indian Heart J. 2021 Jul-Aug;73(4):413-423. doi: 10.1016/j.ihj.2021.06.003. Epub 2021 Jun 18.PMID: 34474751

17.Anomalous origin of coronary artery from the opposite aortic sinus of Valsalva-a single center experience with a therapeutic conundrum.Lanjewar CP, Kumar D, Sabnis GR, Jare M, Phutane M, Shah HC, Reddy S, Borgaonkar D, Thummar A, Kerkar PG. Indian Heart J. 2021 May-Jun;73(3):289-294. doi: 10.1016/j.ihj.2021.03.012. Epub 2021 Apr 3.PMID: 34154744

18.A longitudinal study of antibody responses to selected host antigens in rheumatic fever and rheumatic heart disease. Surve NZ, Kerkar PG, Deshmukh CT, Nadkar MY, Mehta PR, Ketheesan N, Sriprakash KS, Karmarkar MG.J Med Microbiol. 2021 May;70(5). doi: 10.1099/jmm.0.001355.PMID: 33956590

19.Outcomes in non-ST-segment elevation myocardial infarction patients according to heart failure at admission: Insights from a large trial with systematic early invasive strategy. Popovic B, Sorbets E, Abtan J, Cohen M, Pollack CV, Bode C, Wiviott SD, Sabatine MS, Mehta SR, Ruzyllo W, Rao SV, French WJ, Kerkar P, Kiss RG, Estrada JLN, Elbez Y, Ducrocq G, Steg PG.Eur Heart J Acute Cardiovasc Care. 2020 Oct 20:2048872619896205. doi: 10.1177/2048872619896205. Online ahead of print.PMID: 33609103

20.Outcomes in non-ST-segment elevation myocardial infarction patients according to heart failure at admission: Insights from a large trial with systematic early invasive strategy. Popovic B, Sorbets E, Abtan J, Cohen M, Pollack CV Jr, Bode C, Wiviott SD, Sabatine MS, Mehta SR, Ruzyllo W, Rao SV, French WJ, Kerkar P, Kiss RG, Estrada JLN, Elbez Y, Ducrocq G, Steg PG; TAO investigators.Eur Heart J Acute Cardiovasc Care. 2020 Oct 20:2048872619896205. doi: 10.1177/2048872619896205. Online ahead of print.PMID: 33081496

21.Association of PON1 gene polymorphisms and enzymatic activity with risk of coronary artery disease.Godbole C, Thaker S, Kerkar P, Nadkar M, Gogtay N, Thatte U.Future Cardiol. 2021 Jan;17(1):119-126. doi: 10.2217/fca-2020-0028. Epub 2020 Jun 25.PMID: 32583675

22.Amyloid cardiomyopathy as initial presentation of multiple myeloma: devil is in the details.Pawar A, Sabnis G, Kerkar P. Eur Heart J. 2019 Dec 1;40(45):3735. doi: 10.1093/eurheartj/ehz668.PMID: 31557283 No abstract available.

23.Steroid responsive hypereosinophilic syndrome with Loeffler’s endocarditis.

Pawar A, Kumar D, Lanjewar C, Kerkar P. Eur Heart J. 2019 Dec 14;40(47):3868c. doi: 10.1093/eurheartj/ehz673.PMID: 31549721.

24.Heart Rate in Hypertension: Review and Expert Opinion.

Dalal J, Dasbiswas A, Sathyamurthy I, Maddury SR, Kerkar P, Bansal S, Thomas J, Mandal SC, Mookerjee S, Natarajan S, Kumar V, Chandra N, Khan A, Vijayakumar R, Sawhney JPS.Int J Hypertens. 2019 Feb 19;2019:2087064. doi: 10.1155/2019/2087064. eCollection 2019.PMID: 30915238

25.Validation of “left ventricular early inflow-outflow index”: A novel echocardiographic method for quantification of mitral regurgitation in an Indian population with special focus on rheumatic etiology.

Lanjewar C, Pawar A, Patil D, Dhavalagimath M, Sabnis G, Shah H, Kerkar P.Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S235-S240. doi: 10.1016/j.ihj.2018.08.007. Epub 2018 Aug 29.PMID: 30595265

26.Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP).

27.Kalra A, Bhatt DL, Wei J, Anderson KL, Rykowski S, Kerkar PG, Kumar G, Maddox TM, Oetgen WJ, Virani SS.Indian Heart J. 2018 Sep-Oct;70(5):750-752. doi: 10.1016/j.ihj.2018.03.002. Epub 2018 Mar 7.PMID: 30392517

28.Transcatheter closure of large aortopulmonary window in a neonate.

Sabnis GR, Shah HC, Lanjewar CP, Malik S, Kerkar PG. Ann Pediatr Cardiol. 2018 May-Aug;11(2):228-230. doi: 10.4103/apc.APC_158_17.PMID: 29922030

29.A rare endocrine cause of electrical storm – a case report.

Shinde SD, Sabnis GR, Lanjewar CP, Kerkar PG. Eur Heart J Case Rep. 2017 Nov 7;1(2):ytx008. doi: 10.1093/ehjcr/ytx008. eCollection 2017 Dec.PMID: 31020067

30.Appropriateness of elective percutaneous coronary intervention and impact of government health insurance scheme – A tertiary centre experience from Western India.

31.Patil D, Lanjewar C, Vaggar G, Bhargava J, Sabnis G, Pahwa J, Phatarpekar A, Shah H, Kerkar P. Indian Heart J. 2017 Sep-Oct;69(5):600-606. doi: 10.1016/j.ihj.2016.12.018. Epub 2017 Jan 13.PMID: 29054183

32.Guidance on reuse of cardio-vascular catheters and devices in India: A consensus document.

Kapoor A, Vora A, Nataraj G, Mishra S, Kerkar P, Manjunath CN.Indian Heart J. 2017 May-Jun;69(3):357-363. doi: 10.1016/j.ihj.2017.04.003. Epub 2017 Apr 13.PMID: 28648434

33.Modified transjugular approach for percutaneous atrial septal defect closure.

Bhargava RA, Phatarpekar A, Lanjewar CP, Kerkar PG.Ann Pediatr Cardiol. 2017 May-Aug;10(2):197-199. doi: 10.4103/apc.APC_167_16.PMID: 28566830

34.A rare and treatable cause of hypertension in pregnancy.

Bhargava RA, Sabnis GR, Phatarpekar A, Lanjewar CP, Shah HC, Kerkar PG.J Clin Hypertens (Greenwich). 2017 Aug;19(8):801-802. doi: 10.1111/jch.13029. Epub 2017 May 26.PMID: 28548295

35.Percutaneous balloon valvuloplasty with Inoue balloon catheter technique for pulmonary valve stenosis in adolescents and adults.

Lanjewar C, Phadke M, Singh A, Sabnis G, Jare M, Kerkar P.Indian Heart J. 2017 Mar-Apr;69(2):176-181. doi: 10.1016/j.ihj.2016.11.316. Epub 2017 Mar 1.PMID: 28460765

36.Is the Sac Waiting to Rupture? Sinus of Valsalva Aneurysm.

Phatarpekar A, Phadke M, Lanjewar C, Kerkar P.Aorta (Stamford). 2016 Jun 1;4(3):105-107. doi: 10.12945/j.aorta.2016.15.027. eCollection 2016 Jun.PMID: 28097189

37.American College of Cardiology (ACC)’s PINNACLE India Quality Improvement Program (PIQIP)-Inception, progress and future direction: A report from the PIQIP Investigators.

38.Kalra A, Glusenkamp N, Anderson K, Kalra RN, Kerkar PG, Kumar G, Maddox TM, Oetgen WJ, Virani SS; PIQIP Investigators.Indian Heart J. 2016 Dec;68 Suppl 3(Suppl 3):S1-S4. doi: 10.1016/j.ihj.2016.09.005. Epub 2016 Sep 20.PMID: 28038717

39.Giant ischemic left ventricular submitral aneurysm.

Pahwa JS, Patil D, Kohli J, Phadke MS, Lajewar CP, Kerkar PG.Indian Heart J. 2016 Sep;68 Suppl 2(Suppl 2):S168-S169. doi: 10.1016/j.ihj.2015.10.383. Epub 2016 Jan 13.PMID: 27751278

40.Vascular Disease in Young Indians (20-40 years): Role of Hypertension.

Dalal J, Sethi KK, Kerkar PG, Ray S, Guha S, Hiremath MS.J Clin Diagn Res. 2016 Aug;10(8):OE01-6. doi: 10.7860/JCDR/2016/20204.8258. Epub 2016 Aug 1.PMID: 27656492

40.Echocardiographic parameters in clinical responders to surgical pericardiectomy – A single center experience with chronic constrictive pericarditis.

Patil DV, Sabnis GR, Phadke MS, Lanjewar CP, Mishra P, Kulkarni DV, Agrawal NB, Kerkar PG. Indian Heart J. 2016 May-Jun;68(3):316-24. doi: 10.1016/j.ihj.2015.09.027. Epub 2016 Jan 11.PMID: 27316484

41.Cor Triatriatum with Partial Atrioventricular Septal Defect.

Pahwa JS, Phadke M, Patil R, Lanjewar C, Kerkar P. Heart Views. 2016 Jan-Mar;17(1):39. doi: 10.4103/1995-705X.182641.PMID:

42.Response to Letter Regarding Article, “Bilateral Superior Venae Cavae With Crisscross Atrial Drainage”.

Tripathi SP, Nabar AA, Kerkar PG, Telkar HB, Udare AS.Circulation. 2016 Apr 26;133(17):e614. doi: 10.1161/CIRCULATIONAHA.116.022198.PMID: 27143161 No abstract available.

Ongoing Projects

   Ongoing trial status as PI and as Co-I Dr. Ajay Mahajan (PHARMA, GOVT, OA & Thesis)

Status of Trials which are under process as PI and CO-I Dr. Ajay Mahajan (PHARMA, GOVT, OA & Thesis)

Ongoing trial status as PI and as Co-I Dr. Prafulla Kerkar (PHARMA, GOVT, OA & Thesis)

Patient Education 

Patients are educated in detail about the procedure they are about to undergo and counselled for the same and written informed consent taken prior to the procedure.

Dietary and lifestyle measures are conveyed to the patients.

Strict Emphasis on Medication compliance and its importance is made to the patient and their relatives.

Patients undergoing Pacemaker/AICD/CRT are counselled and explained regarding the restriction of hand movements along with the necessary High Protein Diet and Care of the Incision site accordingly.

Community Activities

Regular camps are undertaken to the remote and underdeveloped areas which have less access to healthcare facilities.

During COVID 19 Pandemic, Some of the Faculty and Residents of the Department were transferred to Seven Hills Hospital to work as Covid Warriors.

Future outlook

1. Fetal Echocardiography.
2. Setting up of a valve clinic for evaluation & follow up of complex valvular cases & attempt to provide Transcatheter valve replacement at an affordable cost to the general public.
3. Real Time 4D Echo.
4. Academic Collaboration with International Universities.
5. Continue to serve the underprivileged with state of the art healthcare facilities.