Cardiovascular Journal <p>Under the auspices of the Bangladesh Society of Geriatric Cardiology and International Society of Cardiovascular Ultrasound, Bangladesh Chapter. Full text articles available.</p> <p>Cardiovascular Journal is included on <a title="DOAJ" href="" target="_blank" rel="noopener">DOAJ</a>.</p> Bangla. Soc. of Geriatric Cardiology & Int.l Soc. of Cardio. Ultrasound, Bangla Chapt. en-US Cardiovascular Journal 2071-0917 Prevention of Rheumatic Fever and Rheumatic Heart Diseases in Bangladesh <p>Abstract not available</p> <p>Cardiovasc. j. 2019; 11(2): 91-92</p> KMHS Sirajul Haque ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 91 92 10.3329/cardio.v11i2.40407 Prevalence and Clinical Profile of Chiari network in Bangladeshi subjects: Analysis of 1832 subjects by Echocardiography <p><strong>Background: </strong>The Chiari network is mobile, serpentine, filament-like structures occasionally seen in right atrium near the opening of inferior vena cava and coronary sinus. Sometimes it may cause diagnostic confusion with right atrial pathologies.</p> <p><strong>Methods: </strong>This was a cross sectional study conducted from September 2017 to August 2018 in a private consultation center in Dhaka. All patients who underwent transthoracic echocardiography were included. Chiari network was diagnosed and any relevant clinical condition was recorded.</p> <p><strong>Results: </strong>Out of 1832 echo studies, Chiari network was found in 90 subjects giving a prevalence of 4.91%. More than half (55.6%) had otherwise normal heart, 20% had ischaemic heart disease, 7.8% had cardiomyopathy, 6.7% congenital heart disease, while 3.3% had valvular heart disease.</p> <p><strong>Conclusion: </strong>The Chiari network is often an incidental diagnosis, though it may not be so rare. Clinicians should be aware of it to avoid diagnostic dilemma and to overcome difficulties while performing cardiovascular interventions.</p> <p>Cardiovasc. j. 2019; 11(2): 93-97</p> AKM Monwarul Islam Rakesh Gupta Abdullah AS Majumder Mohammad Arifur Rahman Md Toufiqur Rahman Mohammad Ullah Mohsin Ahmed ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 93 97 10.3329/cardio.v11i2.40406 Comparison of In-Hospital Outcomes of ST Elevation Myocardial Infarction in Patients Undergoing Transradial and Transfemoral Primary Percutaneous Coronary Intervention <p><strong>Background: </strong>Primary percutaneous coronary intervention (PPCI) has been performed traditionally by using femoral approach. Transradial approach has become increasingly popular as it is likely to be less complicating, more comfortable and relatively cost effective having mortality and morbidity benefits. The aim of the study was to compare the in-hospital outcomes of transradial PPCI with that of transfemoral route.</p> <p><strong>Methods: </strong>A total of 80 patients with ST elevation myocardial infarction (STEMI) who underwent PPCI were enrolled in the study. Patients were divided in two groups. Group-I: transradial PPCI; and Group-II: transfemoral PPCI. All patients were followed up during the period of hospital stay and adverse outcomes were observed and compared between the groups.</p> <p><strong>Results: </strong>The result showed that bleeding took place in 2.5% patient of Group-I and 15% patients of Group- II. Vascular complications occurred in 2.5% and 12.5% patients of Group-I and Group-II, respectively. In Group-II, 7.5% patients died with none in Group-I. In Group-II, 37.5% patients experienced some sort of adverse outcomes whereas only 15% of the patients of Group-I did have such experiences (p&lt;0.05). Bleeding and vascular complications were significantly more in Group-II (p&lt;0.05). The mean hospital stay time was significantly lower in Group-I (p&lt;0.001).</p> <p><strong>Conclusions: </strong>Transradial PPCI is safer than transfemoral approach in respect of procedural and post procedural complications including bleeding, vascular complications and mortality. So, transradial approach may be an attractive alternative to conventional transfemoral approach and can be practiced routinely for PPCI.</p> <p>Cardiovasc. j. 2019; 11(2): 98-104</p> Fahdia Afroz Mir Jamal Uddin Md Khalquzzaman Mohammad Ullah Mohammad Khalilur Rahman Siddiqui Shakur Ahmed Abul Khair Md Rezawanul Islam Md Minhaj Arefin Fathima Aaysha Cader Mohammad Arifur Rahman ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 98 104 10.3329/cardio.v11i2.40408 Nonadherence to Drugs among the Hypertensive Patients in Outpatient Department of a Secondary Hospital of Bangladesh <p><strong>Background: </strong>One fifth Bangladeshi adults are hypertensive. Forty percent of them know that they are hypertensive. 53% to 75% hypertensive people have got uncontrolled hypertension. One of the most important causes of uncontrolled hypertension is nonadherence to drugs. We tried to find the causes of non adherence of drugs among the patients with HTN in a secondary care hospital of Bangladesh.</p> <p><strong>Methods: </strong>The study was conducted from March 2018 to June 2018. Total 144 patients with HTN were included in the study. Taking drugs in less than 80% of the days of previous six months was defined as nonadherence. We used Hill Bone compliance scale to find out the causes of nonadherence to drugs.</p> <p><strong>Results: </strong>Out of 144 patients 79 patients (55%) were non adherent to drugs. 36.8% patients forget to take their drugs, 34.02% patients run out of drugs, 29.86% patients miss taking drugs when they feel better, 15.27% patients skip their drugs before going to the doctor and 14.58% patients decide not to take drugs anymore without any specific reason. In most of the patients there are more than one causes of nonadherence. 85.9% patients with nonadherence had uncontrolled hypertension and 66.6 % of the nonadherent patients had target organ damage. Nonadherence is more in elderly patients and with increased duration of hypertension.</p> <p><strong>Conclusion: </strong>Fifty five percent of the diagnosed hypertensive population is nonadherent to their drugs. We must take measures to diagnose HTN among our population and find the ways to make them adherent to their treatment.</p> <p>Cardiovasc. j. 2019; 11(2): 105-113</p> Mohammad Ullah Suman Kumar Saha Md Toufiqur Rahman Md Abdul Karim Rashid Ahmed ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 105 113 10.3329/cardio.v11i2.40409 Transaxillary Surgical Ligation of Patent Ductus Arteriosus in Paediatric Group of Patient <p><strong>Background: </strong>Patent ductus arteriosus is a frequent congenital anomaly with left to right shunt. The aim of this study is to assess 3 years’ experience of transaxillary approach in surgical ligation of patent ductus arteriosus.</p> <p><strong>Methods: </strong>In three years from July 2015 to September 2017, 46 patients underwent in surgical ligation of patent ductus arteriosus through transaxillary approach. All patients had undergone elective operation. Intra operative and post-operative data were analyzed and follow up after 1 month and 3 years.</p> <p><strong>Results: </strong>There were 18 male (39%) and 28 female (61%). Their age range was from 5 months to 10 years months (mean 39.2±24.7 months) and body weight ranges from 4.5 kg to 32 kg (mean 16.05±6.63 kg).There was no mortality or residual patency. Morbidity includes superficial wound infection and chylothorax. All patient discharge on 3rd-5th postoperative day except those who developed chylothorax was discharged after 8 days.</p> <p><strong>Conclusion: </strong>Trans axillary approach for closure of PDA has moved from an alternative incision to a standard posterolateral incision in our experience. It is less traumatic and more cosmetic.</p> <p>Cardiovasc. j. 2019; 11(2): 114-117</p> Md Zahidul Islam Kazi Abul Hasan Khondokar Shamim Shahriar Ziban Rushel Shahriar Moinuddin Saiful Islam Siraji Md Faizul Islam Shahnaz Ferdous Md Azizul Islam ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 114 117 10.3329/cardio.v11i2.40410 A Comparative Study of St Segment Resolution between Diabetic and Non-Diabetic ST Segment Elevation Myocardial Infarction Patients following Streptokinase Thrombolysis <p><strong>Background: </strong>One of the most effective and used (in our settings) methods of reperfusion of ST elevation myocardial infarction (STEMI) is administration of streptokinase (SK) infusion. This study was conducted with the aim to compare ST segment resolution between diabetic and non-diabetic patients with ST segment elevation myocardial infarction after thrombolysis by streptokinase.</p> <p><strong>Methods: </strong>A total of 100 patients with ST elevation myocardial infarction with or without diabetes mellitus were studied from December 2016 to November 2017. Among these half of patients were diabetic while rests were non-diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 min of streptokinase administration.</p> <p><strong>Results: </strong>Failed reperfusion (&lt;30% ST resolution) was significantly higher in diabetic as compared to nondiabetic patients (42% vs. 12%, p &lt;0.001). In hospital complications were more in diabetic patients who has failed reperfusion following streptokinase thrombolysis. Cardiogenic shock occurred in 44% and acute LVF in 30% patients and EF (46.54%) was significantly lower in diabetic patients and higher number of diabetic patients had prolong hospital stay than non-diabetic patients with STEMI.</p> <p><strong>Conclusion: </strong>The outcome of thrombolytic therapy is adversely affected by diabetes mellitus in patients with ST-elevation myocardial infarction.</p> <p>Cardiovasc. j. 2019; 11(2): 118-122</p> Shahriar Iqbal M Saiful Bari MA Bari Mirza Md Nazrul Islam M Abdullah Al Shafi Majumder Zahidul Islam Gana Pati Aditya Gobinda Kanti Paul Shiblee Sadeque Shakil Bishwanath Saha Protap Kumar Paul Mohammad Jalal Uddin ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 118 122 10.3329/cardio.v11i2.40411 Comparison of ST segment Changes in Lead aVR with in-Hospital Outcomes in Patients with First attack of Acute Inferior ST Segment Elevation Myocardial Infarction <p><strong>Background: </strong>Inferior wall ST segment elevation myocardial infarction is considered to be at lower risk than anterior wall STEMI except in some cases. The aim of our study was to evaluate the relationships between on admission ST segment changes in lead aVR and short term in-hospital outcomes in acute isolated inferior myocardial infarction undergoing thrombolysis.</p> <p><strong>Methods: </strong>Total 107 of first attack of inferior STEMI patients were included and all were thrombolysed by streptokinase. The sample population were divided into three groups based on the condition of ST segment in lead aVR on admission and in hospital outcomes were observed: Group –A: ST segment elevation ≥0.5 mm; Group –B: ST segment depression ≥0.5 mm; Group-C: Iso-electric ST segment.</p> <p><strong>Results</strong>: 6.54% of study population had ST segment elevation in lead aVR, 53.27% had ST segment depression in lead aVR and 41.12% had isoelectric ST segment in lead aVR. During hospital stay mortality rates of patients of Group A, Group B and Group C were 33.3%, 5.3% and 4.5 % respectively<strong>; </strong>rates of cardiogenic shock were 33.3%, 8.8% and 2.3% respectively; heart failure rates were 50.0%, 15.8% and 4.5% respectively; rates of recurrent angina after thrombolysis were 66.7%, 33.3% and 6.8% respectively in three groups and the mean LVEF were 40.17, 48.61 and 52.50 respectively.</p> <p><strong>Conclusion: </strong>The on admission-isoelectric ST segment in lead aVR in acute inferior myocardial infarction predicted better in-hospital outcomes in comparison to ST segment elevation and ST segment depression in aVR. On the other hand, ST segment elevation in lead aVR predicted worse in-hospital outcomes than ST segment depression in acute inferior myocardial infarction in spite of reperfusion by thrombolytic.</p> <p>Cardiovasc. j. 2019; 11(2): 123-128</p> Mohammad Jalal Uddin M Saiful Bari MA Bari Mirza Md Nazrul Islam M Abdullah Al Safi Majumder Zahidul Islam Gana Pati Aditya Gobinda Kanti Paul Rakhal Chandra Debnath Shahriar Iqbal Md Shamim Chowdhury Md Saidur Rahman ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 123 128 10.3329/cardio.v11i2.40412 Outcome of Early vs. Delayed Invasive Intervention in Acute Coronary Syndrome Patients Attending a Selected Specialized Hospital: A Comparative Study <p><strong>Background: </strong>This study was to compare the outcome of early versus delayed invasive intervention in acute coronary syndrome (ACS) patients.</p> <p><strong>Methods: </strong>A total of 200 patients with ACS underwent early intervention group (d”24 h, n=100) and delayed intervention group (&gt;24 to 72 h, n=100) after percutaneous coronary intervention (PCI) were enrolled. The probable outcomes were a composite of re-infarction, acute LVF, recurrent ischemia, repeat revascularization, bleeding, stroke or death at 30 days.</p> <p><strong>Results: </strong>Male were predominating (74%vs26%). Left anterior descending artery was the commonest infarct related artery in both groups (p=0.114). Cardiac markers, Cardiogenic shock, Acute left ventricular failure (LVF) and ventilator requirement were significantly higher (p=0.007, p=0.060, p=0.009, p=0.002) and mean duration of hospital stay was longer (p &lt;0.001) in delayed intervention group. At 30 days follow-up improvement of chest pain, LVF and ejection fraction were achieved significantly in patient undergoing early intervention (p &lt;0.001, p=0.016, 54.7±7.4 vs. 48.4±6.9; p &lt;0.001). Adverse outcome like acute LVF (7% vs. 21%; p=0.004), re-infarction (0% vs. 7%; p=0.007), acute kidney injury (AKI) (5% vs. 17%; p=0.007), bleeding (11% vs. 18%; p=0.160), stroke (3% vs. 9%; p=0.074), repeat revascularization (1% vs. 7%; p=0.032), death (0% vs. 5%; p=0.030) was higher in delayed invasive intervention group (p=0.001).</p> <p><strong>Conclusion: </strong>Acute LVF, ventilator requirement and duration of hospital stay were significantly predominating in delayed intervention group. Early invasive strategy in ACS patient associated with lower rates of acute LVF, acute kidney injury, re-infarction, stroke, bleeding, repeat revascularization and death compared with delayed invasive strategy at 30 days of follow-up.</p> <p>Cardiovasc. j. 2019; 11(2): 129-138</p> Masuma Jannat Shafi Sahela Nasrin ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 129 138 10.3329/cardio.v11i2.40413 In-hospital Outcome of Acute Coronary Syndrome Patients with on-Admission Hyponatremia <p><strong>Background: </strong>Coronary artery disease is the commonest form of heart disease and the leading cause of morbidity and mortality throughout the world. Electrolytes imbalance can lead to increase in hospital mortality and morbidity in acute coronary syndrome patients. Our objective was to find out and to compare in-hospital outcome of patients presenting with acute coronary syndrome with or without onadmission hyponatremia.</p> <p><strong>Methods: </strong>A total of 336 patients were included in this study of which 59 patients were in group A (sodium level &lt;135 mmol/l). Group A was subdivided in Group A1 (Na+-134-130mmol/l), Group A2 (Na+-120- 129mmol/l), Group A3 (Na+-&lt;120mmol/l) and 277 patients were in group B (sodium level &gt;135 mmol/l).</p> <p><strong>Results: </strong>On-admission hyponatremia was documented in 16.12 %( 59) of patients with acute coronary syndrome. Among them, 16 patients with acute anterior STEMI, 19 patients with acute inferior STEMI, 19 patients with NSTEMI and 5 patients with unstable angina. In this study, in hospital complications like acute heart failure (81.4% vs. 29.2%, p&lt;0.05), cardiogenic shock (32.2% vs. 15.5%, p&lt;0.05) and in hospital mortality (6.8% vs. 1.1%, p&lt;0.05) were significantly more in the patients with hyponatremia. The frequency of in hospital mortality, acute heart failure and arrhythmia progressively increased with increasing severity of hyponatremia. Logistic regression analysis showed low plasma sodium level was independently associated with in hospital mortality (â =2.13, P =0.027, OR = 8.388, 95% CI 1.268 - 55.488).</p> <p><strong>Conclusion: </strong>In this study on-admission hyponatremia significantly associated with high in-hospital adverse outcome in acute coronary syndrome patients.</p> <p>Cardiovasc. j. 2019; 11(2): 139-146</p> Mohammad Ali Abdul Wadud Chowdhury Khandker Md Nurus Sabah Md Gaffar Amin Sudhakar Sarker Bishnu Pada Saha Md Mashba Ul Haque Jinat Farjana ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 139 146 10.3329/cardio.v11i2.40414 Per-operative Changes of Pulmonary Artery Pressure following Closed Mitral Commissurotomy <p><strong>Background: </strong>Mitral stenosis is often present with pulmonary hypertension. Closed Mitral Commissurotomy (CMC) is a treatment of choice for severe mitral stenosis. In this study, we examined the per-operative changes of pulmonary artery pressure following opening of stenosed mitral valve.</p> <p><strong>Methods: </strong>All these CMCs were performed routinely through the left antero-lateral thoracotomy (4th intercostal space) and dilatation was done by metallic Tubb’s Dilator. Peroperative left atrial and Pulminary Arterial pressures were measured before and after dilatation.</p> <p><strong>Results: </strong>15 patients had undergone CMC. Following CMC, per-operative mean Pulmonary artery pressure was reduced from 45.5±7.1 mm of Hg to 39.0±8.8 mm of Hg (p=0.043). Mean left atrial pressure reduced from 35.9±5.6 mm of Hg to 30.0±9.1 mm of Hg (p = 0.049). At three months follow up after closed mitral commissurotomy mitral valve area at echocardiography was found 2.29±0.18 cm<sup>2</sup>. There was no case of death after closed mitral commissurotomy. Mild mitral regurgitation occurred in 1 patient.</p> <p><strong>Conclusion: </strong>We conclude that there is immediate significant reduction of pulmonary Artery pressure following closed mitral commissurotomy. This reduction is apparently comparable with a similar reduction of left atrial pressure.</p> <p>Cardiovasc. j. 2019; 11(2): 147-151</p> Muhammed Abdul Quaium Chowdhury Mohammad Fazle Maruf Minhazur Rahman Subir Barua Mamunur Rahman Suman Nazmul Hosain ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 147 151 10.3329/cardio.v11i2.40415 Day Care Coronary Angiogram in Bangladesh- Our Experience with 100 cases <p><strong>Background: </strong>In conventional coronary angiography (CAG) by transfemoral approach patients usually need to stay at least one night in hospital. CAG by transradial approach gives the opportunity for same day hospital discharge. The objective of this study was to assess the safety and feasibly of day case CAG in Bangladesh.</p> <p><strong>Methods: </strong>This is a single operator observational study where patients admitted for CAG through transradial (conventional and distal radial) approach were included. Patients were admitted at least 2 hours before the procedure. Hemostasis was done with manual compression followed by tight gauge-rolled bandage. Predischarge criteria had been set and applied to all patients. An emergency telephone number was given to the patient and they were contacted on the next day over telephone.</p> <p><strong>Results: </strong>30 (30%) female and 70 (70%) male were included with mean age 53±9SD years. Patients were discharged from the hospital on an average after 3.3±1.1 hours of the procedure. Only 4(4%) patients contacted to the emergency number. No bleeding complication was noted and 16(16%) patients complained about of some puncture site pain. Radial artery patency was was maintained in 96% of the patient on subsequent follow up.</p> <p><strong>Conclusion: </strong>Same day hospital discharge is a feasible and safe alternative with similar radial artery patency rate. It will reduce the hospital cost and bed occupancy rate in a busy center in Bangladesh.</p> <p>Cardiovasc. j. 2019; 11(2): 152-158</p> Abdul Momen Md Zulfikar Ali Ashraf Ur Rahman Reaz Mahmud Huda ABM Nurunnabi Md Monsurul Haque Iftequar Alam Shudhakor Sarker Mohammad Ali Md Abul Alam Lima Asrin Sayami Sabina Hashem Saqif Shahriar Mir Jamal Uddin ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 152 158 10.3329/cardio.v11i2.40416 Association of CHA2DS2-VASc-HS Score with Adverse In-hospital Outcomes in Patients with Non-ST Segment Elevation Myocardial Infarction <p><strong>Background: </strong>Early detection of patients with non-ST segment elevation myocardial infarction (NSTEMI) who would suffer from adverse in-hospital outcomes is important for the therapeutic decision. Recently it was described that CHA2DS2-VASc-HS and CHA2DS2-VASc score is a predictor for severity and adverse in-hospital outcomes in patients with stable coronary artery disease (CAD) and acute coronary syndrome. The aim of our study was to assess the accuracy of the CHA2DS2-VASc-HS score predicting adverse inhospital outcomes in NSTEMI patients.</p> <p><strong>Methods: </strong>120 patients with NSTEMI were enrolled in this study. The CHA2DS2-VASc-HS score was calculated. The study subjects were divided into two groups. Patients’ with CHA2DS2-VASc-HS score&gt;4 were put into group I and scored” 4 into group II. They were treated as per hospital treatment protocol and followed-up for adverse in-hospital outcomes (Heart failure, cardiogenic shock, recurrent ischemic pain, significant arrhythmia and death).</p> <p><strong>Results: </strong>It was observed that, patients with CHA2DS2-VASc-HS score &gt;4 had more adverse in-hospital outcomes than CHA2DS2-VASc-HS score d” 4 (20% vs. 3.3%, p=0.01). Group I patients developed cardiogenic shock 10%, heart failure 4%, recurrent ischemia 11.7%, significant arrhythmia 1.7% and death 1.7% than group II patients (1.7%, 3.3%, 3.3%, 0% and 0% respectively). By risk measurement, CHA2DS2-VASc-HS score &gt;4 emerged as a risk factor for developing adverse in-hospital outcome (Relative risk=6).</p> <p><strong>Conclusion: </strong>NSTEMI patients with high CHA2DS2-VASc-HS score have more adverse in-hospital outcomes. This score, which involves only clinical parameters, can be used as a predictor of outcomes in this group of patients.</p> <p>Cardiovasc. j. 2019; 11(2): 159-166</p> Poppy Bala Afzalur Rahman Mohammad Ullah Md Monsurul Haque Khurshid Alam Mohammad Arifur Rahman Md Shariful Islam Fathima Aaysha Cader Md Golam Morshed Kanu Bala Delara Afroz ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 159 166 10.3329/cardio.v11i2.40417 Myocardial Strain Imaging Using Two and Three-Dimensional Speckle Tracking Echocardiography: Clinical Applications <p>Cardiac function analysis is the main focus of echocardiography. Myocardial strain &amp; strain rate imaging have emerged as a quantitative technique to accurately estimate myocardial function. In the last decade, two dimensional speckle tracking echocardiography (2DSTE) has gained popularity as a novel technique for strain &amp; strain rate measurement. This technique has been found clinically useful in the assessment of cardiac systolic &amp; diastolic function. 2D strain could potentially be used to differentiate disease from nondisease segments, for identifying early subclinical changes in various pathologies and to learn more about the various strain patterns indicative of specific disease types. A large number of studies have evaluated the role of 2DSTE in predicting the response to cardiac resynchronization therapy in patients with severe heart failure. Emerging areas of applications of 2DSTE include prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer and effect of intracoronary injection of bone marrow stem cells on left ventricular function in patients with acute myocardial infarction. However, 2D imaging methods have limitations in assessing three dimensional (3D) cardiac motion. Experimental studies and clinical investigations revealed the reliability and feasibility of 3DSTE-derived data. In this review, the methodology, validation, and clinical application of both 2D &amp;3DSTE have been discussed.</p> <p>Cardiovasc. j. 2019; 11(2): 167-182</p> Tuhin Haque ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 167 182 10.3329/cardio.v11i2.40418 Ectopia Cordis: A Rare Congenital Heart Disease <p>Three days old female presented with beating heart outside the thoracic cavity. This is a rare congenital abnormality associated multiple abnormalities. Patient came with features of infection. To diagnose routine blood investigation along with echocardiography and CT angiogram of heart,great vessel and abdomen were done. She was diagnosed as functionally single ventricle with hypoplastic branch pulmonary artery with malposed great artery with anomalous pulmonary venous drainage. Thisis lethal variety of ectopic cordis. Our patient had no adequate space in mediastinum to replace heart and she was in septicemia, so managed medically. Patient expired at her 6thday due to sepsis and intracardiac complex congenital heart disease.</p> <p>Cardiovasc. j. 2019; 11(2): 183-186</p> Naharuma Aive Hyder Chowdhury Mohammad Sharifuzzaman Mohammad Abul Kalam Azad Tuhin Haque Jesmin Hossain ##submission.copyrightStatement## 2019-02-27 2019-02-27 11 2 183 186 10.3329/cardio.v11i2.40419