Nathan 🐸 Frogge MD

Ok, if we now have the BATMAN (Balloon-Assisted Translocation of the Anterior Mitral Valve) and ROBIN (Retrograde Radiofrequency Balloon-Assisted Optimization of Neo-LVOT) techniques, I’ll raise the stakes with: 1. SUPERMAN = Supra-annular Ultrasound-guided Prosthesis Expansion for Reducing Mitral Annular Narrowing 2. WONDER WOMAN = Wire-Oriented Navigation for Dynamic Evaluation of Restricted WOrking Mitral Anatomy in Neo-LVOT 3. FLASH = Frontline Laser-Ablation for Subvalvular Hypertrophy 4. GREEN LANTERN = Guidewire-Referenced Electroanatomical Evaluation for Neo-LVOT Luminal Assessment with Non-invasive Tracking of Endocardial Risk Nodes 5. AQUAMAN = Advanced Quantification of Underlying Aortic Morphology for Alignment in Neovalve positioning

Extending congrats to Prashanth D. Thakker, MD, who has been appointed new Program Director for @WashUCardiology Disease Fellowship. Dr. Thakker is succeeding Dr. Andy Kates who has served admirably in this role for the last 16 years. Read more > internalmedicine.wustl.edu/thakker-named-…

@Paddy_Barrett This is a nice image. Where did you get it? Great thread.

There are multiple ways of describing plaque depending on the imaging test used: - Calcified, Non Calcified, Mixed (A combination of the two) - Calcified, Fibrous, Non-Calcifed (Fibrofatty + Necrotic Core plaque) In general, the less non-calcifed plaque, the better. /5

How To Reverse Coronary Artery Disease With Lifestyle Measures. 📕Make sure to bookmark. ✅ 🧵👇 /1

Bill Clinton had 8 exercise stress tests when he was in office and 'passed' each of them with flying colours. He then had a heart test that showed he need coronary artery bypass surgery. Want to know what test he had? 🧵👇 /1

Bill Clinton had 8 exercise stress tests when he was in office and 'passed' each of them with flying colours. He then had a heart test that showed he need coronary artery bypass surgery. Want to know what test he had? 🧵👇 /1

Tense discussions about the 2023 @American_Heart @ACCinTouch chronic coronary guideline at the ACC board of trustees meeting this weekend in Vancouver. Expecting a joint statement soon addressing the controversy and ensuring fallout

@CMcNeelyMD Would take them off the table and discuss unless high-risk features (ongoing CP, unstable, etc) prompting ad hoc PCI. Looks like a relatively low SYNTAX score, so either would be reasonable.

65 y/o M, smoker, no dm. Normal ef. Nonstemi. Pci vs cabg?

Ten current papers for the curious general cardiologist, covering topics including a potential future HTN Rx, new ACC/AHA guidelines for chronic CAD, red meat in CHD & real world TriClip outcomes Sources: @Heart_BMJ,@CircAHA,@ESC_Journals,@JACCJournals,@JAMACardio,@NEJM 1/n

Cats out of the Twitter bag so welcome to DELAWARE (DEliberate Leaflet Augmentation When Anchoring Requires Extra support). The idea is to ⬆️ friction in Ca+ free zones before TMVR in the context of non-circumfrential MAC by piercing & deploying AVP4 across leaflet. more to come

@BaoGTran Not routinely doing 1.25 upfront, but very reasonable in the “wire across and gear won’t go” scenario. I like your stepwise approach here. Thanks for sharing.

Staged PCI of LCx. Pretty rare for me to get a no-cross with CSI. Should have went with Rota 1.25mm burr upfront but I am always wary of entrapment especially in tortuous LCx. Anyone else using 1.25 burr routinely?

Emergency medicine consults

@Tesslagra Wow. What did you use to get there?

They’re everywhere I tell ya’

Peekaboo technique fluoroscopically. Pt hand fully pronated with hub comfortably peeking out so operator can manipulate catheters ergonomically. 5 cm left out with hub just past midline of pt.

@TWilsonMD @perc_surgeon

@perc_surgeon If anyone mentions FFR/iFR of a LIMA I’m going to bl*w my head off.

71M with prior CABG. All grafts open but recent increase in doe. ESE with inducible ischemia in distal lad territory and drop in baseline EF compared to a few years ago. Referred to me to coil branch off lima due to concern for steal. Thoughts?

Hi #CardioTwitter, what would this vessel with the stent, be called? Large septal or small caliber distal LAD with large diagonals wrapping the apex? @NYSCACC @DrBillLombardi @crfheart @thinkmdkane @CCCSymposium_NY @CRT_meeting @GiorgioMedranda @JDawnAbbott1

Asymptomatic 40-50 y/o with new LAFB. CV risk factors include HTN, HLD, OSA, and DM2 — all controlled on recent labs. What would you do? @DavidLBrownMD @CMcNeelyMD @SVRaoMD @prathakker @djc795 @ShariqShamimMD @mmamas1973 @CMichaelGibson @MarcSintek

@Tesslagra What did you use here?

Getting texts from colleagues now. They must think I’m the “Subclavian Whsiperer” 😂

Nephrologist, cardiologist and emergency physician sitting by the airport security gates watching everyone neck their entire water bottles

What's the biggest Mississippi city? Chicago! Why? Because of an ice age water stream If you understand this, you can understand why Chicago is so huge today And more importantly, why some cities thrive while others don't:

@AshleyGWinter Volume of MV repair (not just replacement). MV repair is an intricate & technique-dependent operations. Mortality data may be publicly available depending on state, but should ask. Good surgeons usually happy to disclose. If not forthcoming, red flag. @PujaKachroo

MedTwitter brain trust: A family member (active, in their early 40s) was just told they need a mitral valve repair, possible replacement. The cardiac surgeon offered to talk to me. As a urologist this is outside my wheelhouse. What questions should I ask/what should I know?