Matthew Sample

Today I finally used my extensive training in the Krebs cycle from undergrad and medical school to diagnose and treat a patient. Just kidding. I rounded and did some caths.

@djc795 @jtsaxon Today I learned there is an olive sizing scale.

@jtsaxon Maybe we can start using the same scale as for sizing olives 😂In descending order... Atlas/Super Super Mammoth Super Mammoth Mammoth Super Colossal Colossal Giant Extra Jumbo Jumbo Extra Large Large Superior

Colin makes a great point.

@sandeep_jalli @rational_doc @ShariqShamimMD @Allison_Dupont @jl35wilsonMD @willsuh76 @JayMathewsMD @evandrofilhobr @AntoniousAttall @DrAmirKaki @LAzzaliniMD @DrJayMohan @mandeep_mayo @djc795 @adityadoc1 @SandeepNathanMD @SCAI @SrihariNaiduMD Point being, interventionists need to be capable of performing all interventional procedures. The community needs what the community needs. We need to be trained more like our surgical counterparts as opposed to individual pieces of Interventional Cardiology.

@MSampleMD @rational_doc @ShariqShamimMD @Allison_Dupont @jl35wilsonMD @willsuh76 @JayMathewsMD @evandrofilhobr @AntoniousAttall @DrAmirKaki @LAzzaliniMD @DrJayMohan @mandeep_mayo @djc795 @adityadoc1 @SandeepNathanMD @SCAI @SrihariNaiduMD Disagree on the need for structural training as a part of interventional training. I think we’re selling trainees a false hope.

Starting Jan 1, 2026 PCI Codes changes are summarized below. A couple of new codes have been added 92930 for Bifurcation PCI and 92945 for retrograde CTO. A welcome change, however retro CTO and properly done bifurcation PCI easily takes 2-3 times more time than 92928! #CardioX @SCAI @SrihariNaiduMD @SVRaoMD

@rational_doc @ShariqShamimMD @Allison_Dupont @jl35wilsonMD @willsuh76 @JayMathewsMD @evandrofilhobr @AntoniousAttall @DrAmirKaki @LAzzaliniMD @DrJayMohan @mandeep_mayo @djc795 @adityadoc1 @SandeepNathanMD @SCAI @SrihariNaiduMD Agree this is a huge issue. We’re stepping all over each other. IMO, training duration for IC should increase and include coronary, peripheral, and structural, while also dramatically decreasing trainee numbers.

@ShariqShamimMD @Allison_Dupont @jl35wilsonMD @willsuh76 @JayMathewsMD @evandrofilhobr @AntoniousAttall @DrAmirKaki @LAzzaliniMD @DrJayMohan @mandeep_mayo @djc795 @adityadoc1 @SandeepNathanMD @SCAI @SrihariNaiduMD I don’t kno guys; 300+ IC spots per year is too much… in 5 yrs will have 1500 extra ICs; we will have fewer procedures; despite SCAI being the largest IC association; it has no clue how ACGME approves all these new spots

@SaidAshrafMD @SVRaoMD You get much better pictures with a pigtail. It’s designed to dissipate the pressure equally and not whip wildly around the LV during injection. Agree, myocardial entrapment is rare, but mostly preventable with a pigtail.

@SVRaoMD never done it to avoid even one bad outcome. But having seen colleagues do it regularly for 4 years without any complications with a JR, sometimes I do wonder if the horror is exaggerated.

Endhole catheter ventriculogram

@SVRaoMD Performing a high pressure LVgram with an end hole catheter is done for one of two reasons, ignorance or laziness. Neither are becoming of a professional. It takes 30 seconds to change to a pigtail.

@HeartOTXHeartMD I thought it was ironic that the same journal that taught many, if not most of us, critical appraisal of scientific medical literature would publish something so obviously confounded.

Another formerly respected journal goes down…

@EJSMD @TCHheart @ChristHospital Now THIS is talent. Will be watching for her in the next few years at the CMAs

@MananPareekMD @AmiBhattMD My thoughts exactly.

@AmiBhattMD Great post, but no TAVI story is complete without mentioning Dr. Henning Rud Andersen, the actual inventor: cardiovascularnews.com/henning-rud-an…

Imagine heart surgery without cracking open the chest. Sounds impossible, right? But in 2002, Dr. Alain Cribier made it a reality with transcatheter aortic valve implantation (TAVI). This procedure has saved the lives of patients previously deemed too weak to survive.🧵

Interventional cardiology is largely a cognitive specialty rather than a technical one. Can’t have one without the other.

@Allison_Dupont Did you hike with that sucker?! Dang - 💪

Say you’re a cardiologist without saying you’re a cardiologist. Yosemite with an AED in tow. 🤣

@AaronGoodman33 Who had the better Unplugged?

@jamiemccabeMD Fascinating. Minimal TAVR becoming more minimal all the time. If post TAVR CHB can be reliably predicted, routine same day DC on the horizon.

How long do you keep patients supine following standard transfemoral TAVR? Guess what our single center RCT on the topic suggests… sciencedirect.com/science/articl…

@djc795 @rwyeh @rallamee It was like one long conference - wonderful.

@rwyeh @rallamee Those were the halcyon days of Cardiotwitter…

I was asked to write about social media and cardiology many years ago now. We revisited it thinking about #ORBITA and its impact on the field, reminiscing with @rallamee. A bit shocked how dated it feels now. ahajournals.org/doi/10.1161/CI…

@tristonsmithmd @SVRaoMD @rwyeh @djc795 @bnallamo @CMichaelGibson Agree 100%. Interventional Cardiology/CMS has a gate keeping problem. Was encouraged to see the most recent TTVR CMS NCD not mention volumes. Hopefully this is a trend. Strict volume requirements do limit rural access as well as limit where physicians can live and practice.

Excellent news in my opinion. As I stated in the talk I recently gave at the ACC/ABC joint session at #ACC25 these artificial volume requirements for certification stifle the establishment and growth of cardiac centers in the community and rural settings. They serve nothing more than to worsen and promote inequities in care based on geographic location. Hopefully our societies and CMS follow suit and stop the volume obsession for other procedures as well. @ABCardio1 @ACCinTouch @cardiojaydoc02 @DrQuinnCapers4

Joint Commission reduces volume requirements for heart attack centers jointcommission.org/resources/news… @rwyeh @djc795 @bnallamo @CMichaelGibson

@PradeepYadavMD @djc795 @CMSGov @SCAI @ACCinTouch Honest question here because this is a new commercially available technology - how do new sites have any experience in TTVR if they were part of the clinical trials? Should this be limited only to sites that were in the trial? Does 50 vs 150 TAVR/yr make one better at TTVR?

@djc795 @MSampleMD @CMSGov @SCAI @ACCinTouch Agree but experience in the procedure under consideration!

Welcome ⁦thoughtful National Coverage Analysis on #TTVR published yesterday. Access to healthcare is critical and ⁦@CMSGov⁩ decision is a testament. Great job! Treatment for TR enters a new era! ⁦@SCAI⁩ ⁦@ACCinTouch⁩ cms.gov/medicare-cover…

@djc795 @PradeepYadavMD @CMSGov @SCAI @ACCinTouch What procedure(s) and volume(s) would you suggest matter the most to ensuring high quality TTVR programs?

@PradeepYadavMD @MSampleMD @CMSGov @SCAI @ACCinTouch Every single procedure ever studied has shown that experience matters. There is no reason to believe TTVR is any different.

@djc795 @PradeepYadavMD @CMSGov @SCAI @ACCinTouch David, I have absolutely no insight into that, but would hope that this suggests a new emphasis on outcomes and demonstrated expertise where before volume (of other partially related procedures) served as a surrogate. Do you have any insight here?

@PradeepYadavMD @CMSGov @SCAI @ACCinTouch Glad to see this finally in place so that the field can continue to advance with some predictability. Interesting to see that all of the societal recommendations for surgical and transcatheter volume standards were ignored.

Owning three Labradors is a constant game of either What’s That Smell, Why Are You Wet, or Who’s Throw Up Is This?

@SVRaoMD @djc795 @rajivxgulati @rwyeh @mw_sherwood @KaulP @esbrilakis @jaygirimd @SandeepNathanMD Merge

What system are people using for hemodynamic monitoring in the Cath lab? @djc795 @rajivxgulati @rwyeh @mw_sherwood @KaulP @esbrilakis @jaygirimd @SandeepNathanMD

@naviyd @AmputationSuck Unless it’s DIC…

@AmputationSuck It’s healthiest to bleed and clot at the same rate.

How the human body doesn’t either bleed out or clot off all the time…