Phillip Rowse, MD, FACS

On average, someone in the U.S. dies of a stroke every 3 minutes and 14 seconds. If there is a history of A.Fib, please address the left atrial appendage at the time of cardiac surgery!

@doc_ecmo @LKoliastasis @andreaskardio @KToutouzas Consider etoh septal ablation on table.

@LKoliastasis @andreaskardio @KToutouzas Yep. But would probably try to increase afterload first (noradrenaline) and reduce heart rate (betablocker)…

When you see this doppler signal after TAVI (revealed with valsalva maneuver) you know that you need to act immediately! #CardioTwitter #PCRonline #Suicideleftventricle

@marcelohaertel @JoaoLCavalcante @echo_stepbystep @alexsfelixecho @almasthela @AugustinCoisne @AntonioBarros_ @dr_benoy_n_shah @eromerodorta @NMerke @EchofirstB @kjetilbuer @GE_IanMc @ElenaGalli10 I would worry about cusp thrombosis in the recess of the cusp.

1 month after surgery. Magna Ease mitral bioprosthesis. What is happening? @JoaoLCavalcante @echo_stepbystep @alexsfelixecho @almasthela @AugustinCoisne @AntonioBarros_ @dr_benoy_n_shah @eromerodorta @NMerke @EchofirstB @kjetilbuer @GE_IanMc @ElenaGalli10

Pericardial thickness… 2 mm = Normal 4 mm = Possible Constriction 6 mm = ⬆️ Specificity Constriction

The Brockenbrough-Braunwald-Morrow sign. This sign is characterized by a ⬇️ in arterial pulse pressure after a premature ventricular contraction, accompanied by a significant ⬆️ in peak left ventricular systolic pressure.

Cardiac Surgery @MayoClinic is honored to be ranked No.1 in Newsweek's 'World's Best Specialized Hospitals 2024'! bit.ly/3IgpdBZ

@KSABarns @erictammd @KrithikaRamapr1 Agree

@erictammd @RowseMD @KrithikaRamapr1 Hi Dr. Tam, I'm doing some research and just posted on another of Dr. Rowse's tweets - story same - family member with ECP due to radiation. Did you happen to get any institution/MD recs? Thank you!

Severe constrictive pericarditis. Starting CVP was 25mmHg, CI was 1.77 L/min/m2 and PAP was 51/20. Following near total pericardiectomy CVP dropped to 10 mmHg, CI improved 3.2 L/min/m2, PAP 34/20. @KrithikaRamapr1

@LuisCastroMD @tomcnguyen @JoChikweMD @M_Pompeu_Sa_MD @ovidiogarciav Nice result. In our experience, adequate septal myectomy is usually sufficient to relieve both the dynamic outflow tract obstruction and abolish SAM without the need of mitral valve repair…unless there is an intrinsic mitral valve problem.

HOCM can presents w excessive septal thickness + abnormal mitral leaflet coaptation producing SAM. 58 yo man w 3VCAD, & moderate gradient, septum 17mm and SAM. Modified posterior leaflet MV repair relieved obstruction. @tomcnguyen @JoChikweMD @M_Pompeu_Sa_MD @ovidiogarciav

Proud to be a part of this great @MayoClinicCVS team!

@DinaSRamini @UAZHeart @UofAZSurgeryRes Very cool….just don’t tell the thoracic surgeons😉

My first gastroepiploioc artery conduit harvest in fellowship ✨Tunneled thru the diaphragm and plugged to distal RCA in off pump CABG. @UAZHeart @UofAZSurgeryRes

@JohnTreffalls @Mitrovalvology @MayoClinic @MayoSurgery @MayoClinicCVS @beccatreffalls Superb job! Hope you find your way back to Mayo. All best wishes.

The @MayoClinic/@MayoSurgery is truly a special place. Just completed an amazing month with @MayoClinicCVS that included nearly 20 robotic mitral repairs with an incredible mentor @RowseMD and double scrubbing with my wife @beccatreffalls. Doesn’t get much better than that.

One of the most important slides for all CT Fellows to study!!!

It is not uncommon to see a partial or complete LBBB after myectomy. Watch out for a pre-existing RBBB as this carries increased risk of requiring PPM after myectomy. The asterisks indicates the initial site of myectomy (nadir of the RCC…it is then carried CCW to the AMVL).

Principles of repair: 1. Preserve leaflet mobility 2. Reduce height of PMVL 3. Reduce annular dilatation 4. Restore leaflet coaptation 5. Prevent SAM

When should you advise surgical myectomy for HCM? 1. Effort induced symptoms are unresponsive to medical Rx (beta blockers, calcium channel blockers, disopyramide). 2. Patient is intolerant to medicine (meds make them feel worse).

Severe mitral annular calcification. How do you manage this when performing MVR? Debridement with or without patch? Suture around the calcium bar? Suture into the leaflet? Suture to left atrium? Whatever you can to get a good valve in with no perileak.

Aortic valve regurgitation repair in a Bicuspid valve. Plicate (or limited resection) to eliminate conjoined cusp redundancy, close the sub-commissural triangles (5 0 Ethibond with Teflon pledgets) and resuspend the commissures.

Ingenuity starts with a simple idea.

Looking at a CTA to assess candidacy for robotic mitral repair. What’s the abnormality?

Myectomy specimen(s). I use a #10 knife blade with the aortotomy carried very low into the non-coronary sinus…what do you use?