Delivery cable induced cardiac tamponade during transcatheter closure of atrial septal defect: A preventable complication

http://www.annalspc.com/article.asp?issn=0974-2069;year=2017;volume=10;issue=1;spage=101;epage=102;aulast=Barik

Left main coronary cameral fistula

http://www.jcecho.org/article.asp?issn=2211-4122;year=2016;volume=26;issue=4;spage=123;epage=126;aulast=Mishra

Myocardial calcification in the infarcted myocardium in the anterior lateral wall of left ventricle

Myocardial calcification in the infarcted myocardium in the anterior lateral wall of left ventricle  

“Goodwin triad” of cardiac myxoma

Embolic phenomena
Inflow chamber obstruction
Constitutional symptoms 

Hide and seek of double right coronary artery

Congenital anomalies of the coronary arteries are present in 0.2-1.4% of the general population. ^[1] Double right coronary artery (RCA) is a very rare coronary artery anomaly with an incidence of 0.01%. ^[2] Different authors have used different terminologies for the definition of double RCA like dual RCA, split RCA, duplicated RCA, and other terminologies. Nair et al. ^[3] suggested in conventional coronary angiography that both RCA vessels run parallel in the right atrioventricular groove and both cross the crux. Kunimasa et al. ^[4] Sato et al.^[5] proposed that double RCA should be defined when both supply the blood to the inferior left ventricular (LV) myocardium; thus, both RCAs should course downwardly to reach the interventricular sulcus whether or not they cross the crux. Lemburg et al. ^[6] suggested that adjacent but separate ostia of two RCA vessels with almost similar diameters indicate the presence of true double RCA. Misuraca and Balbarini ^[7] described a right coronary system formed of two distinct branches running very closely together in the atrioventricular groove. The two branches are of a similar caliber and can originate from a single proximal trunk or arise from distinct orifices in the right sinus of Valsalva. The double coronary artery is considered hemodynamically insignificant. It is not immune to atherosclerosis. Because of duplication, it provides better collateral support in case of left coronary atresia or total occlusion...................................


http://www.nigjcardiol.org/article.asp?issn=0189-7969;year=2016;volume=13;issue=2;spage=157;epage=158;aulast=Barik

Missing trees for the forest

A 70-year-old amputee, who was a known case of diabetes, hypertensive, and smoker presented with disabling ischemic symptoms and signs of gangrene in the stump of the left lower leg. He had undergone above knee amputation 2 months back for the gangrene of left foot with an  ankle-brachial index (ABI) of 3. Computed tomography of infrarenal aorta and both the lower limbs arteries revealed total occlusion of common iliac artery, external iliac, and common femoral artery in the amputated leg. The occluded arterial segment was successfully opened percutaneously from left brachial approach. The message of this illustration is never ignore the exact extent of peripheral disease before amputation.

http://www.nigjcardiol.org/article.asp?issn=0189-7969;year=2016;volume=13;issue=2;spage=152;epage=153;aulast=Barik

An eventful second natural history of a congenital bicuspid aortic valve followed up for 40 years

The second natural history of a congenital bicuspid aortic valve with the early symptomatic presentation is eventful. The spectrum takes it start from intrauterine life. The cumulative history may include valvotomy by balloon or surgery, valve replace replacement, stuck valve, thromboembolic complications, thrombolysis, anticoagulation-related bleeding diathesis, redo of replacement, and transcathetor aortic valve implantation. In addition, a retained foreign body granuloma in such cases further lengthens the story. We report a 48-year-old male with congenitally single kidney who underwent redo aortic valve replacement (AVR) and resection textiloma after 15 years of AVR. The eventful second natural history included surgical valvotomy in pre-balloon valvotomy era, AVR, thrombolysis for stuck valve for six times, thromboembolic episode, redo AVR, and excision of paracardiac textiloma.

http://www.nigjcardiol.org/article.asp?issn=0189-7969;year=2016;volume=13;issue=2;spage=136;epage=139;aulast=Barik

Rare presentation of intralobar pulmonary sequestration associated with repeated episodes of ventricular tachycardia

Rare presentation of intralobar pulmonary sequestration associated with repeated episodes of ventricular tachycardia

Degenerative aortic valve disease and coronary artery disease are either side of a coin

Use of dobutamine stress echocardiography for periprocedural evaluation of a case of critical valvular pulmonary stenosis with delayed presentation

Use of dobutamine stress echocardiography for periprocedural evaluation of a case of critical valvular pulmonary stenosis with delayed presentation

Unusual complication of coronary angiogram: Spinal epidural hematoma

Coronary angiogram is considered a relatively safe procedure but unusual complications do occur. Such an unusual case was happened post radial artery approach angiogram leading to severe co-morbidity to patient. We are reporting this case of a female patient who developed acute spinal epidural hematoma two hours after coronary angiogram.

http://www.sciencedirect.com/science/article/pii/S0019483216301651

Thrombus aspiration catheter is a Dottering balloon

What do I answer?

If myocardium will cry

Here was thrombus

Where did it fly?

Posterior pericardial window technique prevent pericardial tamponade after cardiac surgery

Does posterior pericardial window technique prevent pericardial tamponade after cardiac surgery?

Smile is the cover letter

Smile is a cover letter
Never miss it 
If it does help you
Send me a treat

Get it done

Neither retreat, nor maltreat 
Get it done 
Let them howl day and night 
Enjoy the fun

Mind your own business

Wise to be unsocial
When can't fake
Mind your own business
To stop headache

Our health is a function of where we live

Our health is a function
Where we live
City is for business
We must leave [1]
Shake hand 
Let go village
Plant trees, walk and swim
Enough is not knowledge [2]

Good friends are good men

Good friends 
Are always good men
Open their umbrella 
When life does rain

Sacrifice when it is a need

Tree gives up fruit

Fruit gives up seed

Loves to sacrifice

When it is a need

If you win my faith

If you win my faith 
You win me
I can dance naked 
In front of thee

“Open top flask” sign

True education

True education shapes us to be a child :A very little we know ,less is what we carry and the least we are unhappy

BMI has a U-shaped relationship with the risk of AF

Kang SH, Choi EK, Han KD, Lee SR, Lim WH, Cha MJ, Cho Y, Oh IY, Oh S. Underweight is a risk factor for atrial fibrillation: A nationwide population-based study. International Journal of Cardiology. 2016 Jul 15;215:449-56.

Statistical graphics in action: making better sense of the ROC curve

Althouse AD. Statistical graphics in action: making better sense of the ROC curve. International journal of cardiology. 2016 Apr 11;215:9.

Bioresorbable scaffold — A magic bullet for the treatment of coronary artery disease?

Brie D, Penson P, Serban MC, Toth PP, Simonton C, Serruys PW, Banach M. Bioresorbable scaffold—A magic bullet for the treatment of coronary artery disease?. International Journal of Cardiology. 2016 Jul 15;215:47-59.

Comparison of transfemoral vs transbrachial approach for angioplastic reconstruction of chronic total aortoiliac occlusion

http://www.sciencedirect.com/science/article/pii/S0019483216300773

intracoronary nitroglycerin injections through microcatheter are safe and useful to reverse the no-reflow phenomenon in patients who develop no-reflow during PCI

intracoronary nitroglycerin injections through microcatheter are safe and useful to reverse the no-reflow phenomenon in patients who develop no-reflow during PCI

Whole-exome sequencing identifies a novel mutation of DSG2 (Y198C) in a Chinese arrhythmogenic right ventricular cardiomyopathy patient

http://www.internationaljournalofcardiology.com/article/S0167-5273(16)30558-7/abstract

The antegrade transvenous approach for CoA

The antegrade transvenous approach for CoA 

The streetlight effect

A policeman sees a drunk man searching for something under a streetlight and asks what the drunk has lost. He says he lost his keys and they both look under the streetlight together. After a few minutes the policeman asks if he is sure he lost them here, and the drunk replies, no, and that he lost them in the park. The policeman asks why he is searching here, and the drunk replies, “this is where the light is.”

Kiss is contagious

Kiss is contagious

A crowd is an agreement

A crowd is an agreement

Character serves life

Look serves eyes
Skill serves crisis
Character serves life

Sit with a broken

Stand with the greats 
Sit with the broken 
Stay with sick

Dedication itself is award

Lifetime achievement award needs the dedication of entire life

Outline is wine

Outline is wine 
Until the stoppage
Don't feel fine

Man went into city

River with its either side forest cover 
Seeing, was everyone becoming a lover 
Now, destroying everything for ever 
Man has fled to city to enjoy skyscrapers

When you win ?

"First they ignore you. Then they laugh at you. Then they fight you. Then you win." ~Nicholas Klein

Mind is wilder than wild

Mind is wilder than wild 
It is more than a kid
More thoughts it's feed 
In sleep also it dreams 
Loves roaming in difficult side

Cartoon of life

I carry your heart with me

i carry your heart with me (i carry it in

my heart) i am never without it (anywhere

i go you go, my dear; and whatever is done

by only me is your doing, my darling)

i fear

no fate (for you are my fate, my sweet) i want

no world (for beautiful you are my world, my true)

and it’s you are whatever a moon has always meant

and whatever a sun will always sing is you

here is the deepest secret nobody knows

(here is the root of the root and the bud of the bud

and the sky of the sky of a tree called life; which grows

higher than soul can hope or mind can hide)

and this is the wonder that's keeping the stars apart

i carry your heart (i carry it in my heart)

                                                                 - 1904-1962, by E. E. Cummings. 

Sixteen headings of a good curriculum vitae

1. Tertiary education

2. Honours and awards

3. Employment

4. Current role and responsibilities

5. Academic committees

6. Professional committees

7. Teaching experience

8. Theses examined

9. Commercial/industry collaboration

10. Academic management/leadership courses attended

11. Editorial responsibilities

12. Referee for

• Manuscripts:
• Research grant applications:
• Professorial promotions/appointments

13. Research grants received

14. Presentations at international scientific meetings

15. Presentations at national meetings

16. Publications

• Books
• Book chapters
• Refereed journals
• 4.Refereed conference publications
• Publications in the lay press (newspapers, magazines)
• or scientific magazines
• Abstracts, letters to the editor or conference proceedings

We need friends to live

In the air ,we need oxygen to survive
Among people, we need friends  to live

Happy Birth Day :"Wish strength in your wings"

Happy birthday Oh'  my queen and king
Wish strength  in your wings
Let those blessed  carry you  high
Success is waiting to hug and tell you  hi

With love
Father 

How to write a research paper ?

Outline of research paper 

Exercise brings sleep for body ,Peace brings sleep for mind

Exercise brings sleep for body
Peace brings sleep for mind

THE WORLD'S TINIEST PACEMAKER

Combined percutaneous transvenous mitral commissurotomy and left atrial appendage closure as an alternative to anticoagulation for rheumatic atrial fibrillation.

Combined percutaneous transvenous mitral commissurotomy and left atrial appendage closure as an alternative to anticoagulation for rheumatic atrial fibrillation.

Only freedom has gate pass for both Hell and Heaven,Wish, you choose the best

Disheartening Disparities

Three years ago, my father woke up in the middle of the night in our home in Harare, Zimbabwe, with chest pain and palpitations. When that happened once before, we’d waited 3 hours for an ambulance, so my father convinced my mother that ambulances were too unreliable. They decided to wait until 7 a.m., when our primary care doctor, who was also an old friend, opened his office. When it was time to go, my mother helped my father change out of his pajamas and climb slowly into the car. She could tell he was in pain, and she drove quickly but gently over the potholed Zimbabwean roads so that he could be the first patient seen by the doctor that Saturday morning.

Our family doctor, who’d been treating my father’s heart disease for more than 20 years, took one look at a single-strip EKG and knew that the situation was serious. He called the insurance company to authorize an emergency evacuation to South Africa. But the insurance agent refused to approve the evacuation without the expert opinion of a cardiologist. It was 7 a.m. on a Saturday, and the handful of cardiologists in Zimbabwe were asleep.

While the doctor argued over the phone with the insurance company, my father, a stoic ex-soldier in his 50s, whispered to my mother, “I think I’m going.” She could see the terror in his eyes before they rolled back and he collapsed into the waiting-room armchair. My mother shrieked, and the doctor ran in, put my father on the floor, and began chest compressions to try to revive his lifeless body. The insurance agent called back 30 minutes later to approve the evacuation — but my father was already gone. My mother sobbed, as sniffling patients watched her nightmare unfold.

A year after we lost my father to hypertrophic cardiomyopathy, I began medical school in New York. Aware of the disease’s genetic basis, I underwent the screening echocardiogram that I’d been putting off for the previous year. An ocean away from home, I had an experience with cardiac care that could not have been more different from my father’s.

The technician, expecting nothing out of the ordinary as she slid the probe over my chest, paused suddenly and then called the attending for help. The doctor, himself confused, spent several more minutes looking at images of my heart before he called a more experienced colleague. I listened intently as the senior doctor explained to his colleague the anomalies visible on the screen, diagnosing me with a variant of the disease that had killed my father.

In the freezing room, gooseflesh overtook my body as I felt my world turn upside down. As a physician-in-training, I never imagined I’d become a teaching case myself. I began writing an exam vignette in my head, “A 25-year-old, previously healthy medical student has an echocardiogram after his father dies suddenly . . . .”

I reacted the only way I knew how. I worked extra hard in class to understand cardiac pathophysiology (it didn’t come naturally). I spent hours in the library scrolling through academic articles and abusing my printing privileges to learn more about my genetic curse. I became the most informed health care consumer possible.

When I Skyped with my mother to tell her the news, we got cut off because she’d had no electricity at home for 3 days and the generator had finally run out of gas. I realized I took for granted my school’s fast Wi-Fi and library databases that gave me access to more information about hypertrophic cardiomyopathy than our family doctor had had during the 20 years he treated my father. When I was in college, my father would ask me to bring home books about heart disease so he could learn more about his condition. He barely knew how to send text messages, let alone search the academic literature. I’d never thought twice about the technology and skills my U.S. higher education afforded me for intellectualizing my distress.

A week after my diagnosis, I met with the senior cardiologist. He’d sent my scans to an international expert at the Mayo Clinic. Together, they decided that I should have an automatic implantable cardioverter–defibrillator (ICD) placed as soon as possible. It would save my life if I had a potentially fatal arrhythmia. The cardiologist referred me to an electrophysiologist on the same floor for an appointment that same day. My father had struggled, in his last hours, to find a heart specialist anywhere in Zimbabwe. In a single hour, I’d received elite care from four cardiologists — more than the number serving Zimbabwe’s entire population of 14 million.

Cardiovascular disorders are the most common cause of death worldwide. More than 80% of deaths due to cardiovascular disease occur in developing countries like Zimbabwe.1 Traditional global health efforts, with agendas determined primarily by funding streams, have focused on infectious diseases such as HIV–AIDS, malaria, and tuberculosis because such investments can produce more immediate and measurable results than targeting of chronic diseases could achieve. Only in 2008, when the World Health Organization launched an action plan for addressing noncommunicable diseases, did funders and global institutions start to take note of noninfectious causes of poor health in developing countries.2

Such neglect filters down to primary care, where providers place little emphasis on preventive medicine or patient education. My father had had a previous heart attack, was overweight, and continued to smoke and drink heavily. He routinely visited our primary care doctor, but once his checkup was over, the two of them would step outside and share cigarettes as they caught up on each other’s lives. Health care systems in Zimbabwe and other developing countries still lack a culture of prevention. Most people served by the public health care sector do not routinely receive primary care services, and when they do, their care is rudimentary at best. Screening guidelines for most cancers, for example, are impractical and rarely followed in sub-Saharan Africa. By contrast, my U.S. doctors urged me to have an echocardiogram and then prescribed interventions to protect my health and my heart. They instructed me to reduce my caffeine and alcohol consumption, stop lifting weights, and have an ICD implanted as soon as possible.

Had my father received preauthorization, he would have had to survive a 3-hour helicopter flight to a South African hospital where his health insurance would not have covered the full cost of his care. When my surgery date arrived, I walked across the street from my dorm to the hospital. The defibrillator was so new that there were not yet randomized, controlled trials for it, so I consented to participate in a multicenter trial studying outcomes with this latest device. Even the surgery was brand new — my defibrillator was placed under the skin over my rib cage, rather than under my pectoral muscle, where most devices are inserted. This technique was being tested for young patients who wanted an active lifestyle. Once the cardiologists finished, a plastic surgeon closed the incision for the best aesthetic results — recognizing that I might still want to impress people with my shirt off. The hospital team discharged me with antibiotics and painkillers, follow-up appointments, and pamphlets about my new ICD.

I was back at medical school in a week, but each time I walked into the modern hospital, I thought of my father. I was lucky. Most young people who die of hypertrophic cardiomyopathy are diagnosed at autopsy, after they collapse during a marathon or a high school football game. I wondered whether my father would have lived longer with my lucky combination of education, resources, and geography.

My family still lives in Zimbabwe, where there are no ICDs or heart surgeons or, in some places, ambulances. I often imagine a far more likely trajectory in which I’m not in medical school in the United States, I don’t have four attentive cardiologists, I don’t even have steady electricity or access to reliable public health information. That is the reality for the 28,000 people who die of heart disease every year in Zimbabwe.3 The $40,000 subcutaneous ICD that rubs against my rib cage is a constant reminder of these inequalities — and my responsibility to become the kind of doctor who will work to reduce them.

Trees care us without care from us

My mother’s tongue

My mother’s tongue

How to use an AED to help save a life

Pigtail assisted tracking of guide catheter for navigating the difficult radial: Overcoming the “razor effect”

Pigtail assisted tracking of guide catheter for navigating the difficult radial: Overcoming the “razor effect”

Current role of beta blocker in cardiovascular practice

Current role of beta blocker in cardiovascular practice 

A rain drop won’t enjoy that falls in sea

"A drop won’t enjoy that falls in sea"
It misses
-Jumping from hill
-Daring forest and wild
-Playing with roots
-Kissing leafs
-Talking to grass
-Breaking hard soil
-Sleeping in soft soil
-Quenching thirst of God's people (all species)
-Playing with kids
-Rolling in the field
-Singing all the way to home
--Hugging long waiting grandma
                                                                                 



                                                               -Bring kids to grandma home in summer holidays

Time takes back everything except given love

Time takes back everything except given love

World uniform day

Let us shake hand and celebrate one day as world uniform day :We belong to world ,one family

Do you know what does CITY mean ?

C:Cutting

I:Innocent

T:Trees

Y:Yatra 

Coronary artery perforation during angioplasty

http://www.slideshare.net/ramachandrabarik/coronary-perforation

Antonym of brave

Brave begets brave 
Weak & co hide in cave

LIVE case: Rotablation of left circumflex and LAD

 LIVE case: Rotablation of left circumflex and LAD

Triple inversion

Inversion 1:Situs inversus
+Inversion 2:Atrial inversion
+Inversion 3:Great artery inversion (DTGA)

Triple inversion 

Author's disclosure

Hemolysis induced by PMIVSD occluder

The anchored heart appearance

New Generations of Drug-Eluting Stents – A Brief Review

Does it take too long to publish research?

mimansa: (3x-1)^7, then addition of all cofactors is =?

mimansa: (3x-1)^7, then addition of all cofactors is =?: Question :(3x-1) 7 , then addition of all cofactors is =? if cofactors are A7,A6,A5,A4,A3,A2,A1,A0 Solution 1.        3x-1=3x-1 2.  ...

mimansa: A does half as much work as B in three-fourth of t...

mimansa: A does half as much work as B in three-fourth of t...: A does half as much work as B in three-fourth of the time. If together they take 18 days to complete the work, how much time shall ...

Statistical Methods for Cardiovascular Researchers

http://circres.ahajournals.org/content/118/3/439.abstract?etoc

mimansa: The ratio of the incomes of P and Q is 5 : 4 and t...

mimansa: The ratio of the incomes of P and Q is 5 : 4 and t...: The ratio of the incomes of P and Q is 5 : 4 and the ratio of their expenditures is 3 : 2. If at the end of the year, each saves 1600, then...

Smile

Everybody may leave you ?
But not your smile !
An oasis for your love ?
Please have  for a while !
Smile   is infectious !
Some  wish  valued
Others use to  elude !
U decide my friend
The 1 U salude?

mimansa: If x/(b -c)(b+c—2a)= y/(c -a)(c+a-2b)= z/(a -b)(a+...

mimansa: If x/(b -c)(b+c—2a)= y/(c -a)(c+a-2b)= z/(a -b)(a+...: If x/(b -c)(b+c—2a)= y/(c -a)(c+a-2b)= z/(a -b)(a+b-2c) then the value of (x + y * z) is? Solution :Let all three ratios are equal to...

mimansa: If α+β+γ=1, α^2+β^2+γ^2=6, α^3+β^3+γ^3=8 then α^4+...

mimansa: If α+β+γ=1, α^2+β^2+γ^2=6, α^3+β^3+γ^3=8 then α^4+...: If α+β+γ=1, α 2 +β 2 +γ 2 =6, α 3 +β 3 +γ 3 =8 then α 4 +β 4 +γ 4 =? Solution: If x, y and z replaces α β and γ for easy writing, then ...

Fossa ovalis

Fossa ovalis

Abnormal origin of right coronary artery and use of Tiger catheter through femoral route