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Source: Dr.S.Venkatesan MD
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No, we can ’ t allow BAV to be a threat,.. to our heart-throb !
Interventional cardiologists generally do not believe (rather relish) in simple balloon dilatations to remove any vascular blocks. It is a mundane job for their talent-ridden hands. After conquering the coronaries, we made exclusive the valvular stents. No surprise, TAVR has taken over the aortic interventions with all its glamour and vigor, though it is definitely not an ideal choice in all.
SCAI, the prestigious journal in Interventional cardiology has a recent article , that has a not-so pleasant message for TAVR lovers.
PIIS2772930323004453Download
It poses a direct challenge to cardiologists’ heart...
Source: Dr.S.Venkatesan MD - September 18, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Life style modification & CVD prevention : Spot the new entry
Discussing lifestyle modification is an essential cliché in every preventive cardiology consult, For most, it still means good nutrition exercise, and stress relief. It is true, that the average human longevity has increased considerably in the last century. However, this apparent gain in life expectancy by the stunning discoveries in science ( 10 years ?) has already been eaten up, by the self-inflicted, poor styles in life. The new kid on the block, i.e. social media is playing a powerful amplifying effect.
Spot a new entry in lifestyle interventions.
Here is a fresh list of lifestyle modifications from the ...
Source: Dr.S.Venkatesan MD - September 8, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
New ESC 2023 Cardiomyopathy guidelines: Truths trail by 17 years!
It was 2006
Allow me to recount an unassuming piece of a PowerPoint presentation from my institute, Madras Medical College, at the annual Cardiological Society meeting in New Delhi. The paper was categorized under miscellaneous sessions. I vividly remember the day. I have to admit, It was a nearly empty hall E, located in the basement of Hotel Ashoka. After the talk, I looked up to find that neither the chairman nor the handful of kind academic souls had any questions or comments to make. Pausing for a few moments, I quietly walked down the podium with an inexplicable silent pain.
The title of the presentation was &#...
Source: Dr.S.Venkatesan MD - August 27, 2023 Category: Cardiology Authors: dr s venkatesan Tags: cardiomyopathy Dilated cardiomyopathy hypertrophic cardiomyopathy ischemic cardiomyopathy Uncategorized drsvenkatesan ESC 2023 new cardiomyopathy guideline ndlvc non dilated cardiomyopathy Source Type: blogs
What does statin do to Cholesterol absorbtion from Intestine ?
A.Reduces
B Increases
C.No effect
D. Iam not sure
Does this sound a difficult question ?
Many felt so. Hence, I decided to ask the all too popular AI machine.
It became a brief little chat with GPT, that surprised me .
https://chat.openai.com/share/6b96c54e-ad52-472a-9ebd-b7b1e1c762be
Statin: Some untold story.
Last century’s rockstar drug, statin do stimulate Cholesterol abosorbtion as well as hepatic synthesis.We must be aware, It is a less popularised truth (Intentionally ? ) among the cardiolgy community,
Ofcourse LDL comes down, at the cost of residual pre -choleterol particles th...
Source: Dr.S.Venkatesan MD - August 19, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
I am 49 … not out, how about you TAVI ?
This post was written after coming across a case report Oxford medical case report.
What is the life of a prosthetic Aortic valve?
The standard answer needs to be, mechanical valves can last up to 25 years or more. But, we are in a techno-conflict era. Instead of working on the longevity of the valve, ( with concerns for long-term OAC ) we fell for the biological valves. Curiously, this has made the durability of the valve, a less relevant discussion in many centers. We get excited when some company brings out a long-lasting bio-prosthetic valve that can live up to a maximum of 15 years.
Now, ...
Source: Dr.S.Venkatesan MD - August 1, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized prosthetic aortic valve starr edwards valve tavi valve Source Type: blogs
What is your top three high & low value cardiac Intervention?
High value
1.Pacemaker
2.Heparin in Acute coronary syndrome
3.Diuretic therapy for Cardiac failure & Pulmonary edema
Low value
1.PCI> 24 hrs after STEMI
2.Most CTO Interventions
3.AF ablation
Strong contenders for high value Interventions
1.PTMC
2.Thrombolysis & DAPT
3.Diet and excercise modulation
Strong contenders for low Value Intervention
1.TAVI in young & SAVR eligible population
2.Mitra clip
3.LAA appendage closure
Final message
Unfortunately, most of us are blinded (Artificially though!) to quality check, outcome assessment, and comparativ...
Source: Dr.S.Venkatesan MD - July 19, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized ethics in cardiology What is Interventional cardiology Source Type: blogs
Cardiology Image quiz : A diagnosis no one wants to make !
What is the lesion?
It looks like an Intracardiac tumor, a myxoma ? a variant of HCM ? Is it a hydatid cyst, ?
No it’s not. I can give one clue. This is a man-made condition.
Oh ok, did this happen inside the cath lab ?
Yes, you got it, right. But need a diagnosis.
Can you give me one more clue?
This patient was undergoing PCI for chronic total occlusion.
So, it must be a complication. Then I need to know the list of complications during CTO PCI.
Yes, but you may not find this one in the conventional list. Let me come out with the answer.
...
Source: Dr.S.Venkatesan MD - July 10, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
What happens to FFR after stenting ?
A simple question with mammoth repercussions in the revascularization world.
How was the question ? Was it difficult ?
Don’t worry, it wouldn’t be the same even for elite cardiology experts worldwide. It is not a Himalayan task, though, to find an answer. All it requires is a simple FFR run through pre and post PCI (Now RFR, iFR, QFR). Surprisingly, very few inquisitive minds wanted to do this. I can find 5 related papers. The fifth one is very specific: REPEAT-FFR study. Go through at least that one paper and find the answer yourself.
Cardiology fellows it is worth reading about this important stud...
Source: Dr.S.Venkatesan MD - July 8, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized acc aha bari 2 d courage study eapci epicardial myocardial dissociiation es guideinnedmt ffr ffr rfr qfr ffr vs oct ISCHEMIA trial medical management for cad myocardial revascularisation ORBITA study Source Type: blogs
Distal vs proximal strut crossing in BFL : Who is trying to sustain the confusion ?
Anyone who is flushed with millions can become a member of The Hurlingham Club in London or the Yacht Club in Monaco, or other glamorous clubs in the world. But, EBC* is different. Only cardiologists are privileged to enter. EBC is obviously different and unique. It is probably the only club addressing exclusively bifurcation coronary lesions. Apart from immense pride and academic entertainment, it teaches us some deep technical points. (By the way, BFL* is the minuscule spoke in the gigantic wheels of global atherosclerosis)
Approach to BFL
Although 90% of BFL still require a only drugs or simple single stent or a p...
Source: Dr.S.Venkatesan MD - July 4, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Stent migration : A rare & tricky complication !
Stents have become essential coronary jewelry in global CAD care. The usage of these glamorous metals inside the human heart has crossed many millions, and aiming for a billion. Obviously, when used on such a large scale un-toward events are not an exception.
Stent migration
While the complication list of coronary stenting hangs long, fortunately, stent migration is a rare event. , Though, early geographical miss is common during deployment, these episodes don’t come under stent migration. Stent dislodgement during the procedure is a more common technical defect.If not recognized it may be wrongly label...
Source: Dr.S.Venkatesan MD - June 14, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized stent migration Source Type: blogs
Cath lab nightmares : Beware, this one has no simple cure !
Cath lab nightmares may be a cliche word for all of us. Still, It has become a mandatory topic in any cardiology conferences and live workshops. These sessions are always popular and crowded as Interventional cardiologists are eager to get tips from other experts, on what to and what not to do in the cath lab in crisis situations. While stuck in an unexpected problem, these tips really help us come out of this, with shared expertise, presence of mind, skills, innovation, etc.
I used to wonder, what the word nightmare really mean. Thesaurus helped to find it. Nightmare: A Terrifying feeling due to some untoward event ...
Source: Dr.S.Venkatesan MD - June 8, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
When ” Cath lab viability ” competes with myocardial viablity … Just carry on !
Pure science
Whenever possible ,before doing a coronary revascularisation procedure , check twice the segments you try to perfuse is really short of blood supply and truly needs the procedure. Don’t ever waste your resources and try to blood-feed the dead myocardium. It’ can never be awakened !
Pragmatic science
I was conversing with my colleague recently , who has grown into suave , Interventional cardiologist with a huge academic & societal repute .He owns a personal cathlab and planning to get one more.
I learnt a non-academic reality lesson from him .
When planning myocardial revasascularisation, ...
Source: Dr.S.Venkatesan MD - June 8, 2023 Category: Cardiology Authors: dr s venkatesan Tags: bio ethics cardiology wisdom cardiology-ethics Cardiology-Statistics cath lab tips and tricks Medical education Medical ethics medical quotes medical satistics Two line sermons in cardiology wisdom in cardiology cath lab viablity vs Source Type: blogs
Feeling guilty now, for a past professional crime !
Having retired, find little more time in browsing the academic images lying idle in old computers.It is intresting, still a tiring job to pick any useful learning stuff, from heaps of data hiding in different hard drives.
This set of ECGs I could retrive from the year 2011, A 31-year-old male presented to our CCU at 4.50 PM.
The treatment was Initiated in 10 minutes and completed in an hour, (Those days cath lab wasn’t functioning 24/7, more importantly, there was no external interference with our professional decision-making process)
The ECG was repeated at 7.15 PM
I think this case is much rele...
Source: Dr.S.Venkatesan MD - May 26, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
A “ hard talk ” with chat GPT : Evidence vs Experience in medicine
Dr .S.Venkatesan MD
Good morning GPT. Let me introduce myself . I am a medical doctor, practicing cardiology, in Chennai India. I have had a long-standing query in very fundamental principles of the practice of medicine. Just wanted to chat and clarify with you.
Welcome, I am here to help you
Medicine is both art and a science. In recent times the movement of evidence-based medicine (EBM ) is trying to overturn the clinical experience. I have a feeling it is not fair. We can’t create evidence for every decision we make in clinical science right?
My first question is
Can experience-based medical care be...
Source: Dr.S.Venkatesan MD - May 5, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized ai in medicine artificial intelligence chat gpt in medicine evidence vs experience based medicine Source Type: blogs
Advantages of Left ventricular hypertrophy (LVH)
This is a 15-year-old post about LVH, written in 2008. Few of my colleagues, now agree with this, but still hesitate to oblige in the open, suggesting it is too good to be true! Re-posting it for your own assessment. Surprised, why cardiology community didn’t consider this observation worthy to pursue.
Advantages of Left ventricular hypertrophy (LVH)
Left ventricular hypertrophy is one of the most common clinical cardiac entity.It is recognised either by ECG or echocardiography.LVH has a unique place in cardiology as it can imply a grossly pathological state or a marker of healthy heart as in physiologica...
Source: Dr.S.Venkatesan MD - May 4, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
