The oldest civilisation on the face of the Earth can be traced to India, home to the largest democracy of our times. Fast forward five millenia, a young nation at 78 places the aortic cross clamp most of others on a per diem basis. Somewhere in between, Donald Nixon Ross, who has been interred in this great Hall of Fame [1] opined that “it is rare to know of surgeons who can perform an operation better and often, seamless than its namesake, and among the few there are, Sampath Kumar is one”. It gives us great pleasure to introduce at the time of his induction in the Paediatric Cardiology Hall of Fame, one of finest humans our profession is privileged to have – Professor Arkalgud Sampath Kumar. Kumar has earned the peerage accorded to few surgeons in our milieu for his lifelong commitment to patientcare, teaching, research and innovation – making him the definition of a quadruple threat in academic surgery. Coming from Professor Anderson, we deem it an honor to present this character-sketch of this gentleman surgeon and mentor, who has the rare distinction of expanding the horizons of paediatric cardiovascular surgical care in the public, private and philanthropic institutions, among others through this encomium.

The patient, the first of twins, weighed 714 g at birth. On day 14, ultrasound revealed a large methicillin-resistant Staphylococcus aureus-induced atrial vegetation; the tumour grew to 6 mm by day 19. Percutaneous removal was selected due to the risk of pulmonary embolism. We used a three-loop EN Snare system. The procedure was safe and successful.

A five-year-old boy was diagnosed intraoperatively with the Raghib complex, consisting of an absent coronary sinus, persistent left superior vena cava, and an atrial septal defect associated with a ventricular septal defect. The surgical management, which included intracardiac rerouting of the left superior vena cava to the right atrium along with closure of both septal defects, was successfully performed.

Tuberous sclerosis complex is syndrome that affects several organs. Cardiac manifestations include rhabdomyoma, which could lead to intracardiac obstruction of blood flow. In the present case, the so far lowest documented Everolimus blood level of 2–3 ng/ml led to tumour regression. Repeated Everolimus stopping and restarting for clinical reasons serves as a proof-of-concept for Everolimus therapy in tuberous sclerosis complex.

We report the case of a 10-month-old infant presenting with dilated cardiomyopathy caused by septal dyssynchrony linked to a right septal accessory pathway-mediated pre-excitation. No atrioventricular reciprocating tachycardia was reported, but this pre-excitation resulted in left septal dyssynchrony. After the introduction of flecainide therapy, the antegrade pre-excitation disappeared on ECG, leading to normalisation of left ventricular function.

We report the case of a 5-year-old boy with severe pulmonary arterial hypertension due to partial anomalous pulmonary venous connection and atrial septal defect. Sequential combination therapy using multiple pulmonary vasodilators enabled safe surgical repair. In this case of severe pulmonary arterial hypertension—associated with partial anomalous pulmonary venous connection and atrial septal defect—the treat-and-repair strategy proved effective.

We report a rare case of a 3-month-old male infant with Down syndrome, severe pulmonary arterial hypertension (a large patent ductus arteriosus, an atrial septal defect, and a giant hepatic arteriovenous malformation). Initial treatment involved hepatic arteriovenous malformation embolisation using 17 Azur® CX Peripheral Coils, resulting in clinical improvement. However, persistent pulmonary arterial hypertension led to patent ductus arteriosus closure using an 8-mm Lifetech Cera™ vascular plug after a successful balloon occlusion test. Post-intervention, the patient showed symptomatic relief, reduced right ventricular overload, and atrial septal defect shunting shifted to left to right. This is the first reported paediatric case combining these features successfully managed through a multidisciplinary and stepwise treatment approach, eliminating the need for liver transplantation.

Long-term results of total aortic cusp replacement such as the Ozaki procedure in paediatric patients have rarely been reported. We describe the 13-year follow-up of a 9-year-old boy with aortic valve regurgitation who underwent total aortic cusp replacement without the need for reintervention. His aortic valve regurgitation is mild with peak pressure gradient of 22 mmHg at the last follow-up.

This is a case of a 6-week-old male with D-TGA and multiple large ventricular septal defects who presented with oxygen desaturations into the 60s. He had initially undergone palliative pulmonary artery banding at a different institution, for concern that patch closure of his large ventricular septal defect would compromise ventricular function. We decided to undergo 3D printing and 4D modelling of his heart to delineate his ventricular septal defect anatomy in preparation for their closure and arterial switch operation. A 4D CTA showed a large perimembranous outlet ventricular septal defect and a very large “swiss cheese” muscular defect. We then segmented the heart and produced 3D models of the diastolic and systolic phases and printed 1- and 1.5x-sized 3D heart models. The 3D and 4D models were used to evaluate all ventricular septal defects from both sides of the ventricular septum to plan their closure. The systolic phase of the CTA demonstrated near obliteration of the apical muscular ventricular septal defects. The patient underwent complete surgical repair at 4 months. The posterior septal, apical, and large anterior muscular ventricular septal defects were closed by bovine pericardium. However, the large perimembranous and inlet ventricular septal defects were closed with a single patch, sparing the intervening muscle band that was thought to contain the conduction system. From the models, the most distal apical ventricular septal defects were shown to close with ventricular contraction during systole. Therefore, apical exclusion of the RV was not required. Thus, this additional information enabled an optimal surgical approach to efficiently close ventricular septal defects in need of closure without futile attempts at closing remote ventricular septal defects.