Jon McDonagh, MD

@jamiemccabeMD Awesome!

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…

@JReinerMD Had one today

How many interventionalists have seen an object like this when you step on fluoro? This is not my first time. It’s probably not my 20th. Only in America.

@NajranPavan @Tesslagra @DrDavidWellsIR @DrDamianMullan @MRAkid @terumoisuk If I was the patient I would want femoral

Open to debate…radial loop, negotiated with a combination of a micro catheter and hydrophilic 5F catheter…loop remained, minimal discomfort..what would you do next? Carry on procedure? @DrDavidWellsIR @DrDamianMullan @MRAkid @terumoisuk

@DocSavageTJU @mmamas1973 @mirvatalasnag @djc795 @GreggWStone @cardioPCImom @DLBHATTMD @Drroxmehran @SandeepNathanMD @Pooh_Velagapudi @Costa_F_8 @SrihariNaiduMD @Hragy @aymanka @fischman_david Why is this important? What we ‘call it’ has no impact on patient outcome

OSH cath report “There was a 20% in-stent restenosis”. This statement is… #CardioTwitter #ACCFIT @mmamas1973 @mirvatalasnag @djc795 @GreggWStone @cardioPCImom @DLBHATTMD @Drroxmehran @SandeepNathanMD @Pooh_Velagapudi @Costa_F_8 @SrihariNaiduMD @Hragy @aymanka @fischman_david

@CMichaelGibson Sham comparison trials important for interventions looking for improvement in subjective outcomes like QOL

The gold standard in drug trials is to compare a new drug to placebo in a blinded trial. But for most medical devices, placebo trials have never been done. Should device trials be required to compare the new device to a placebo or sham device? Why or why not?

@SVRaoMD @TChengot And I thought we weren’t supposed to do theombectomy? 😉

@TChengot Amazing case and great result! Do you think it was embolic?

38yo female - no prior history presents with chest pain… after soiling myself - I went to work

@alexmeshkin I’ve been a physician for 22 yrs and can attest to having cared for critically ill young people with group A strep many times prior to 2020.

I never heard of healthy 24 year olds being hospitalized for Strep prior to 2020.

@Goldcoastcardi1 @ShariqShamimMD @Ravinay Had a similar case recently - used buddy wire w BAV from the other femoral.

Please share your trouble shooting approach when you are unable to cross TAVI through a severely stenosed Bioprosthetic valve. Our case- MG 90mm Hg. EF 30%. Super calcified 27 mm mosaic. Axillary approach. Femoral not able to take anything more than 6F.@ShariqShamimMD @Ravinay

@KAlaswadMD Nice!

Can you do PowerKnuckle inside a stent? The answer is in the next

@RSohnMD Very cool. Must be going around- had very similar case last week

@jon_mcdonagh No balloon or stent. Now that flow is restored, letting it heal naturally

PCI for #SCAD (when can’t wire true lumen) ➡️ STAR technique (subintimal tracking & re-entry) Couldn’t wire true lumen of OM branch. Engaged stump (Fig 1) w/ Corsair to exchange wire for Fielder XT which was knuckled distally (video) to restore flow (Fig 3)

@yuripridemd Is this for real?

Osler would be so proud of how far we've come

@agtruesdell In use the towel- keeps them from getting wrapped / twisted

Bifurcation PCI. How do you “mark” your wires? Me: side-branch wire “in” fold of towel (then flip towel open/closed as necessary to manipulate/load wire), main branch wire “outside” fold. Others?... #radialfirst

@GBarnesMD @umichCVC @ThrombosisRese1 PERT teams have been the cart before the horse.

Important work from @umichCVC showing that sometimes implementing a PERT program can reduce advanced therapy use. We need RCTs (e.g., HI-PEITHO, PE-TRACT) to help us know when to use these tools for acute #PE. sciencedirect.com/science/articl… @ThrombosisRese1

@MegriMohammed Have never seen an actual echo like this that ended well

TO DRAIN OR NOT TO DRAIN!? (Pre-capillary PHT) with pericardial effusion and shock

@DavidLBrownMD @VictorDayan1 @HIBulut_CVP Is FFR or angiography the useless test?🤷‍♂️

@VictorDayan1 @HIBulut_CVP FFR and angiographic severity can be discordant in both directions. One of many reasons it's a nearly useless test.

Hey @generalelectric - *might* be time to update the demographic categories in your MUSE ecg reading software. Among others we don’t generally use the word ‘Eskimo’ up here in Alaska #CardioTwitter

@adnanalkhouli @JACCJournals Seems likely to reflect the underlying substrate as technique has only become smoother and less traumatic

Worrisome temporal increase in PCI procedural stroke, a new study from NCDR Cath PCI registry documents jacc.org/doi/10.1016/j.…

@MollySilkowski HS troponin is single handedly exploding the cost of healthcare

Raise your hand if you’ve ever been personally victimized by the high sensitivity troponin.

@VictorDayan1 @wordfinga @EACTS You cannot measure and unconfound unmeasured confounders

Swedish registry comparing CABG vs PCI for LM after matching for confounding AND unmeasured confounders. Data speaks for itself. PCI should be reserved for frail, elder patients. For those reluctant due to the early curve separation, this did not occur in stable angina @EACTS