Alzheimer's disease and type 2 diabetes mellitus tend to occur together. We sought to identify protein(s) common to both conditions that could suggest a possible unifying pathogenic role. Using human neuronal butyrylcholinesterase (AAH08396

Hemolysis related to occluder, prosthetic valve, and prosthetic ring used for mitral valve annuloplasty are not very unusual. However, hemolysis related to transcathetor closure of post-myocardial infarction ventricular septal defect (PMIVSD) is infrequent. A close follow-up for spontaneous resolution with or without blood transfusion has been reported in a few cases. Occasionally, surgical retrieval is unavoidable or lifelong blood transfusion is required if surgery cannot be done because of higher risk. In this illustration, we have showed a close follow-up of a case of hemolysis induced by atrial septal occluder used for VSD closure after myocardial infarction. Despite successful device closure of PMIVSD which is difficult, a close watch is needed for complications like residual leak, device embolization, and hemolysis.

Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate?

The angioplasty of chronic total aortoiliac occlusion using transfemoral is controversial. From March 2014 to December 2015, four consecutive patients (4 males; mean age 58.2±6.8 years; age of range 51-65 years) underwent angioplasty and stenting of TASC-D occlusion. In all the cases, we failed to cross from femoral approach. On switching over to left brachial access, angioplasty was done successfully in all. There was no procedural site complication or clinical evidence cerebral thromboembolism. Self-expandable stents were implanted in all with adequate pre and post dilation. Complete revascularisation was achieved in two cases and in other two cases, the angioplasty to the left aortoiliac carina was staged. Therefore, it is better to avoid femoral approach as initial step to cross chronic TASC 2007 type D (chronic total aortoiliac occlusion or called extensive aortoiliac disease) because of failure to cross retrogradely due to subintimal course of guide wire leading to retrograde aortic dissection.

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It is very rare to encounter tubercular chronic constrictive pericarditis and hypertrophic cardiomyopathy together. A 49-year-old man with a history of tuberculosis was evaluated for right heart failure. There was extensive pericardial calcification, fibrosis and calcification of the left lung, and hypertrophic obstructive cardiomyopathy ( Figure 1, Video 1). The coronary angiogram was normal. The systolic and diastolic movement of the right coronary artery in the densely calcified pericardial cavity was interesting (Figure 2, Video 2). The densely calcified pericardial cavity with the top being relatively free of calcification resembled an open top flask. A left ventricular angiogram was suggestive of hypertrophic obstructive cardiomyopathy (Video 3). Pericardial resection and Morrow's procedure were performed in the same session.Figure 1. (A) Chest radiograph in posteroanterior projection, showing the stigma of old healed Koch's disease (fibrosis and calcification in the left lung; arrow A) and a densely calcified pericardium (arrow B). (B) Left ventricular angiogram in right anterior oblique view, showing densely calcified pericardium in the atrioventricular groove (arrow A) and significant left ventricular outflow tract obstruction (arrow B).Figure 2. Right coronary angiogram in right anterior oblique view, showing a normal right coronary artery surrounded by thick and densely calcified pericardium. The pericardial cavity was relatively free of calcification at the top (''open top flask'').