Qualification: 
MS, MCh, DNB
kirungopal@aims.amrita.edu

Dr. Kirun Gopal completed his MBBS from Kottayam Medical College in 2001. He then did his General Surgical residency at Kasturba Medical College, Manipal finishing in 2005. His Cardiac surgery training was from the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum finishing in 2009.

He then worked as an Assistant Professor in the Department of Thoracic & Cardiovascular Surgery, Kottayam Medical College for 3 years.

Subsequently, he went to the Cleveland Clinic, USA, to do a 2-year fellowship in advanced adult cardiac surgery and a 1-year fellowship in aortic surgery. Here he had the opportunity to work with world leaders in cardiac and aortic surgery with exposure to latest advances in minimally invasive cardiac surgery, redo cardiac surgery, heart and lung transplantation, and complex open and endovascular aortic surgery.

After returning from the USA, he joined as Assistant Professor at Kottayam Medical College for 3 months before joining the faculty here at Amrita Institute of Medical Sciences as Associate Professor.

Education and Professional Experience

  • 2017 (January- April): Assistant Professor CVTS, MCH Kottayam
  • 2016-2017: Aortic Fellow, Cleveland Clinic, USA
  • 2014-2016:  Clinical Fellow, Adult cardiac surgery, Cleveland Clinic, USA
  • 2010-2014: Assistant Professor CVTS, MCH Kottayam
  • 2007-2010: Residency in CVTS, SCTIMST, Trivandrum
  • 2006: Registrar CVTS, SUT Hospital, Trivandrum
  • 2002-2005: Residency in General Surgery, Kasturba Medical College, Manipal
  • 1995-2001: MBBS, Kottayam Medical College

Publications

Publication Type: Journal Article

Year of Publication Title

2018

S. Gangadharan, Sundaram, K. R., Vasudevan, S., Ananthakrishnan, B., Balachandran, R., Cherian, A., Dr. Praveen Varma, Gracia, L. Bakero, Murukan, K., Madaiker, A., Rajesh Jose, Seetharaman, R., Kirun Gopal, Menon, S., Thushara, M., Jose, R. Liza, Deepak, G., Vanga, S. Babu, and Jayant, A., “Predictors of acute kidney injury in patients undergoing adult cardiac surgery.”, Ann Card Anaesth, vol. 21, no. 4, pp. 448-454, 2018.[Abstract]


Background: Acute kidney injury (AKI) after cardiac surgery (CS) is not uncommon and has serious effects on mortality and morbidity. A majority of patients suffer mild forms of AKI. There is a paucity of Indian data regarding this important complication after CS.

Aims and Objectives: The primary objective was to study the incidence of AKI associated with CS in an Indian study population. Secondary objectives were to describe the risk factors associated with AKI-CS in our population and to generate outcome data in patients who suffer this complication.

Methods: Serial patients (n = 400) presenting for adult CS (emergency/elective) at a tertiary referral care hospital in South India from August 2016 to November 2017 were included as the study individuals. The incidence of AKI-CS AKI network (AKIN criteria), risk factors associated with this condition and the outcomes following AKI-CS are described.

Results: Out of 400, 37 (9.25%) patients developed AKI after CS. AKI associated with CS was associated with a mortality of 13.5% (no AKI group mortality 2.8%, P = 0.001 [P < 0.05]). When AKI was severe enough to need renal replacement therapy, the mortality increased to 75%. Patients with AKI had a mean hospital stay 16.92 ± 12.75 days which was comparatively longer than patients without AKI (14 ± 7.98 days). Recent acute coronary syndrome, postoperative atrial fibrillation, and systemic hypertension significantly predicted the onset of AKI-CS in our population.

Conclusions: The overall incidence of AKI-CS was 9.25%. The incidence of AKI-CS requiring dialysis (Stage 3 AKIN) AKI-CS was lower (2%). However, mortality risks were disproportionately high in patients with AKIN Stage 3 AKI-CS (75%). There is a need for quality improvement in the care of patients with AKI-CS in its most severe forms since mortality risks posed by the development of Stage 3 AKIN AKI is higher than reported in other index populations from high resource settings.

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2009

S. Gadhinglajkar, Sreedhar, R., Gopalakrishnan, S., Sadiq, A., Rao, M., and Kirun Gopal, “A Left Ventricular-to-Right Atrial Shunt in a Patient With a Perimembranous Ventricular Septal Defect: Role of Intraoperative Transesophageal Echocardiography”, Journal of cardiothoracic and vascular anesthesia, vol. 23, no. 5, pp. 675-8, 2009.[Abstract]


ADHESION OF TRICUSPID valve leaflets around margins of a perimembranous ventricular septal defect (VSD) gives rise to aneurysmal transformation of the membranous septum, which partially or completely occludes blood flow through the VSD. A case of a perimembranous VSD with a left ventricular–to–right atrial (LV-to-RA) shunt, which was misinterpreted as a tricuspid regurgitation (TR) jet on preoperative transthoracic echocardiography (TTE), is reported. Correct diagnosis was made by intraoperative transesophageal echocardiography (TEE).

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2009

S. Misra, Sinha, P. K., Koshy, T., Sandhyamani, S., Parija, C., and Kirun Gopal, “Accurate Localization and Echocardiographic-Pathologic Correlation of Tricuspid Valve Angiolipoma by Intraoperative Transesophageal Echocardiography”, EchocardiographyEchocardiography, vol. 26, no. 10, pp. 1228 - 1231, 2009.[Abstract]


Angiolipoma (angiolipohamartoma) of the tricuspid valve (TV) is a rare tumor which may be occasionally misdiagnosed as right atrial (RA) myxoma. Transesophageal echocardiography (TEE) provides accurate information regarding the size, shape, mobility as well as site of attachment of RA tumors and is a superior modality as compared to transthoracic echocardiography (TTE). Correct diagnosis of RA tumors has therapeutic significance and guides management of patients, as myxomas are generally more aggressively managed than lipomas. We describe a rare case of a pedunculated angiolipoma of the TV which was misdiagnosed as RA myxoma on TTE and discuss the echocardiographic-pathologic correlates of the tumor as well as its accurate localization by TEE. (ECHOCARDIOGRAPHY, Volume 26, November 2009)

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2007

P. Kumar, Kirun Gopal, and Ramnani, S., “Clinical forensic evidence in burns: Rescuer burns”, Burns, vol. 32, pp. 1032 - 6, 2007.[Abstract]


In the literature no systematic study is available on rescuer burn for victims of burn injury. This is a retrospective study of nine patients (five admitted and four outpatients) were treated in this hospital as rescuer burns in 3.5 years. All nine patients were males. Average age of the patient treated on outpatient basis was 47 years (ranging between 44 and 52) and total burn area ranged for 1-4%. Average age of the five patients treated on inpatient basis was 32.6 years (ranging between 30 and 34). The total burn area ranged from 14.5 to 38%. During the period of study, in addition to nine rescuer burns, one patient sustained burn before the rescue attempt due to the victim hugging the rescuer. Based on the study of patterns of burn, these patients were found to have three grades of burn injury: Grade 1--upper extremity involvement only. (A) only one upper extremity involvement, (B) both upper extremities involvement, Grade 2--upper extremity/extremities and face involvement, Grade 3--upper extremity/extremities, face-neck, adjacent chest and lower extremity involvement.

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2007

Kirun Gopal, Raj, A., Rajesh, M. R., Prabhu, S. K., and Geothe, J., “Sternal tuberculosis after sternotomy for coronary artery bypass surgery: A case report and review of the literature”, The Journal of Thoracic and Cardiovascular Surgery, vol. 133, no. 5, pp. 1365 - 6, 2007.[Abstract]


A 72-year-old man presented with upper back pain for 1 month and swelling over the sternum of 4 days’ duration. He had no constitutional symptoms. One year earlier he had undergone coronary artery bypass surgery with an uneventful postoperative recovery. Clinical examination revealed a fluctuant swelling over the body of the sternum. There was mild tenderness but no erythema. Radiography of the chest and thoracic spine showed normal results (Figure 1). He had a total white blood cell count of 10,000/mm,3 with a differential count of 68% neutrophils and 30% lymphocytes, and an erythrocyte sedimentation rate of 105 mm/hour. Drainage of sternal abscess and removal of underlying possibly infected sternal wires were performed. Intraoperatively, a large abscess cavity (3.5 × 3 cm) was detected in the body of the sternum unrelated to the sternal wires. The cavity was lined with infected granulation tissue extending to the inner table of the sternum. The granulation tissue was curetted until healthy bleeding bony surface was observed. The pectoralis major muscle was mobilized to cover the defect, and the wound was closed in layers over a suction drain. The patient had an uneventful postoperative recovery and was relieved of back pain. The curetted tissue was sent for histopathology and bacterial culture. Histology revealed a caseating granulomatous lesion with sequestrum formation consistent with tuberculous osteomyelitis (Figure 2); the routine culture was negative, whereas BACTEC culture revealed mycobacterium tuberculosis (TB). On a 4-drug antituberculous regimen, the patient is doing well at 6 months.

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2006

Kirun Gopal and Neelakandhan, K. Sankaran, “Migrated Kirschner Wires In The Mediastinum: A Case Report And Review Of The Literature”, The Internet Journal of Thoracic and Cardiovascular Surgery, vol. 8, no. 2, 2006.[Abstract]


The use of Kirschner wires for the fixation of fracture dislocations is a common and standard practise. We report here a case of migration of two kirschner wires used for fixation of the sternoclavicular joint. The broken distal ends had migrated into the superior mediastinum and the pericardial cavity. The wires were retrieved via an anterolateral thoracotomy. Migrated kirschner wires into the mediastinum have been reported sporadically in the literature. Early diagnosis and removal of such foreign bodies are important in order to avert potentially fatal major structure involvement.

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Presentations

  • Aortic Dissection Series from a Tertiary Hospital in South India at the 58th Annual Conference of Indian Association of Cardiovascular & Thoracic Surgeons, February 2012, Kolkata.
  • Cardiopulmonary Resuscitation at the weekly meeting of the Rotary Club, Kottayam, December 2011.
  • Heart Surgery at the annual district seminar meeting of Rotary Club, Kollam, July 2011.
  • ACLS guidelines at the monthly meeting of Kottayam Surgical Club, April 2011.
  • Simultaneous Revascularisation of Lower Limbs and Bowel from Novel Inflow Source as a Poster Presentation at the IACTS National Conference, Mahabalipuram, February 2011.
  • Chest Trauma at the Trauma CME conducted at Matha Hospital, Kottayam, November 2010.
  • Unusual Cause of Pulmonary Venous Chamber Obstruction Post Senning Procedure as a poster presentation at the PCSI National Conference, Cochin, October 2008.

Professional Memberships

  • Indian Medical Association
  • Association of Surgeons of India