Dr Suleman

Proud to be a #PCRPresenter and #PCRLV, @PCRonline See you in @PCR London Valves, November 27-29

@dr_faraz_ahmed Thanks faraz

Brilliant stuff Suleman. All that hard work paid off. Well deserved! @docsuleman

Today marks the publication of our ABC sizing app validation study. This multicenter study demonstrates that meticulous sizing, utilizing the ABC algorithm, can significantly mitigate the risk of catastrophic root rupture complications in balloon-expandable valves. The app is available on app store for download.

@JakeFleshner OS for heart procedures. Quantavi.ai

Pitch me your company in 2 words Angel invested in 40+ companies and always looking for more

@Cappy_Nate Followed

@docsuleman We'd be lucky to! Only lets me add followers.

Started an Actual Canadian Builders group chat. -Hardware -Software -Space -Defence -Web3 -Health -AI -Energy -Manufacturing You name it. But it's a Canadian only zone. 🇨🇦 If you want in, drop your name in the comments and ping anyone who should be there! LFG! 💪🇨🇦🏗️🚀

Building QuanTAVI, a software that turns heart CT scans into clear decisions for heart valve procedures (which valve to use, risks, and future planning). I’m a heart specialist who also builds software, so I understand both the clinical problem and how to solve it. Edge: Real doctor + builder (used in real patient workflows, not just a demo) Helps doctors make decisions, not just measurements (unlike competitors) Focus on long-term planning for patients, not just one procedure (big shift happening now) Early stage, looking to scale globally.

Investing $250k in non-US based builders. 40 spots, 8 weeks, San Francisco. Flights/housing/food covered + visa support. This Summer Looking for: technical/product builders pre/early idea cofounder-seeking Comment your edge, I’ll get back to you!

If post-dilating of Evolt is being blamed for 6–7 year failure, maybe we should ask whether the valve remembers crimping - arguably the most aggressive moment of its life 😅

@GilbertTangMD @JACCJournals Very insightful take. Vendor-independent TAVR selection matters in low-risk patients who will outlive their first valve, an anatomy-driven (not just risk-driven) approach that prioritizes repeatability should guide the first implant. Working on a structured solution - more soon.

Interesting Evolut low risk #TAVR 6y data just out @JACCJournals . While there were ⬆️ reintervention in TAVR over SAVR arm, a deep dive and understanding of bioprosthetic valve material and design, and potential implications should be noted: - we know bovine pericardial valves in SAVR and now TAVR fail primarily by stenosis not regurgitation. In SAVR, porcine valves fail mostly due to AR while bovine pericardial valves fail due to AS. This was shown in PARTNER3 low risk where there were more thrombosis in TAVR but not higher reintervention in TAVR, likely bc failure mode was AS and progressive prosthetic AS is quite well tolerated - porcine pericardial valves may fail via a different mechanism. EV failure here appeared primarily due to commissural tear similar to what we see in porcine SAV surgically. This AR from failed EV appeared to be due to large non compliant balloon post dilatation to ⬇️PVL, since the waist of EV is < inflow where it seals against the annulus. As a result, the waist of the EV would’ve stretched beyond its nominal frame dimensions (eg a 24mm waist stretched to 28mm using a 28mm non compliant or even semi compliant balloon against an annulus of 28mm). This may risk leaflet or commissural damage. We now have strict IFU from @MDT_StructHeart on non compliant post dilatation sizes to mitigate against this potential issue. We know acute AR is poorly tolerated so these pts really had no option other than reintervention on the failed TAVR. This also highlights the importance of choosing the right anatomy for TAVR to avoid aggressive post dilatation to ⬇️PVL. Obviously we need to minimize PVL in TAVR but if mild or greater PVL is expected, SAVR should remain a durable alternative in low risk pts, where we’ve seen even mild PVL in real world TVT registry with S3 can ⬆️☠️ although P3 7y didn’t show this. - other self expanding TAV designs different from EV may not be susceptible to this issue in terms of non compliant balloon post dilatation damage to the leaflets. Long term data will shed light on this - in this context we also need to question about balloon valve fracture post TAV-in-SAV using a non compliant balloon inflated to high pressure potentially beyond the waist of EV that may risk leaflet damage. Pre fracture even though risking acute AR and one can control pace to unload the LV, may be safer and avoid leaflet damage - given we now have 3 commercially available TAV, 2 of which are approved for low/intermediate risk pts, catering the valve choice to the specific pt anatomy and considering clinical, demographic and social factors altogether to offer the best therapy to our pts, is key to optimize durability and lifetime management. Optimizing index TAVR is now more critical than ever, and SAVR in hostile TAVR anatomy in low or even intermediate risk pts (ie avoid unsafe TAVR) should remain in our ❤️team discussions and recommendations

@JibbyD @remitly Wise

What service are you guys using to send money? Used @remitly for a while. Initially their transfer rate was very close to google, and there was no fee. Then they introduced a fee, and now they raised the fee. The exchange rate is also not good. Time to find a new service.

@realarainmd @Hragy Would love to see your novel approach! How do you ensure your gantry rotation is truly orthogonal to CTO? Our app’s first two modules aim to generate a true orthogonal artery view from fluoro lines—though the math is still experimental.

@realarainmd @Hragy Thanks 🙏. Yes i wanna work on traning AI on ivus images to detect wire and then show a 3d rendered image of wire location just like OCT does. I wanted dicuss that in our meeting that day. Currently im about to finish AI TAVR analysis software and then will need your help on this

3D wiring vs. TDADR (or any ADR) Here is a random ‘doodle’ from some weeks ago, when I was thinking hard about 3D wiring. I am a visual learner, and my phone is full of these ‘proof of concept’ pictures. This is my understanding of the role of 3DW vs. ADR in #CTOPCI. 🤔

@realarainmd sorry guys i was busy lately. you can access it from naviwire.app. the first two section are experimental but the last section (IVUS Wire) is something you want.

@realarainmd if you want i can give you link to my (underdevlop) app for better Visual understanding of 3d wiring

@realarainmd @LubbDup @yadersandoval @DOcazionez @esbrilakis @Hragy @SripalBangalore @ColletCarlos @evandrofilhobr Excellent case. We use always OCT, which might have picked it even if it was missed by IVUS (which it didn't). Your point regarding Ischaemia trial well taken but what is your threshold to stent a vessel? Any rupture plaque or more than a certain percentage stenosis?

In a week full of exciting IVI guided PCIs and peripheral interventions, this case took the 🎂! 51 y/o woman sent home from the ER with non cardiac CP after a normal workup. Readmitted a week later with DOE. This is her angio. What to do now? FFR/CFR, IVUS, OCT, NIRS, or PET?

@realarainmd @DrBillLombardi @Can_CTO Thank you for the encouraging words. You’ve been a true inspiration to all of us!

@docsuleman @DrBillLombardi @Can_CTO You have a great career ahead Suleman. Well done and keep up the good work! 👏🏼

Just had the pleasure of discussing HDR at #CanCTO2025, with @DrBillLombardi moderating! What a fantastic conference - organic, wholesome, and distinctly Canadian. I had the opportunity to speak on HDR for in-stent occlusions. A huge thank you to the organizers @Can_CTO, and congratulations on such a well-deserved success!

@Laserrman @ErwMulia @ISIC_Official Impressive as always. Do you think clockwise rotation of wire tip on ivus require anticlockwise on torquing tool . as catheter takes 180 degree turn and everything is inverted now?

#CTO #3Dwiring #TDADR This presentation for #EssentilaCTO. Real time 3Dwiring ; faster.@ErwMulia @ISIC_Official

Just wrapped up an incredible time at #NYValves with the @McMasterU team leading three exciting innovation projects: 🔹 @docsuleman on gradient correction 🔹 Dr. Sheth on TAVR repeatability 🔹 I presented our AI-driven model for expansion prediction. Grateful for the learning, the city, and the momentum. Till we meet again, NYC! #TAVI #StructuralHeart #Innovation

@warkaa21 @McMasterU The conference was such a great mix of learning and fun - made even better by attending it with you! Loved exploring New York together! I am really going to miss you at the hospital.

Get the latest updates in #TAVR at #NYValves2025! 🔥 Explore breakthrough data on valve performance, patient outcomes, and new tech transforming aortic valve care. @AugustinCoisne @ANVoraMD @SammourMD @Docsuleman #CardioEd #CardioResearch #CardioX #CardioTwitter