Wassef Karrowni

#STEMI & cardiac arrest in ED —> Impella —> LM trifurcation PCI (T stenting)

@DrMarwanRefaat @Maisara_Alrayes Sorry for your loss; الله يرحمهم

May the soul of my wife’s relatives - Dr @Maisara_Alrayes and other family members of the Alrayess family rest in peace in paradise. They were killed today by the Israeli terrorists by targeting Alrayess street in Gaza.

@JHRo67 @kelsey_brugman Yes, used Sentinel device. Luckily there was no embolization.

@karrowni @kelsey_brugman Do you do this with cerebral protection. What if something breaks off?

Aspiration of large mobile thrombi associated with Watchman Flx implanted a year ago; patient presented with embolic stroke. Flash catheter used from Penumbra. Easy to aspirat the free material; left organized material on surface of device behind.

#ICE image of @PenVascular Flash cath aspirating large #Tricuspid valve #vegetation; IJ vein approach.

Variable depth of implant in TAV-in-TAV in different patients to avoid significant leaflet overhang. Target node 6 or 5 of Evolut #TAVR

@rosensteinl I agree. I hope all is well!

Congratulations to the next iteration of @IntMedatIowa residents! Welcome to the Hawkeye family!

@GaneshMuthappan @Adolfoferrero No we didn’t see central leak

@Adolfoferrero @karrowni And you don’t get central leak?

Antegrade #Lampoon followed by #TMVR Edwards Ultra 26 + 5 cc for non-surgical patient with severe MAC and mixed disease

@CardiacCTson Thanks Gardar! Yes it should help; this patient did have very small LV and wouldn’t have been candidate otherwise.

@karrowni Impressive work Wassef. So does adding the Lampoon mean that we might decrease the high rejection rate for severe MAC patients with small LV?

@GaneshMuthappan Thank you! We could have used the 29 but the predicted neoLVOT with Lampoon was much smaller; also the 26 is Ultra so have longer skirt which is helpful.

@karrowni Wow great case. Curious why 26+5 instead of 29?

Revascularization of #CTO of popliteal artery through primary pedal access #TAMI and using drug coated balloon angioplasty #CLIFighters

Our case series of inter/high risk acute PE pts treated w low-dose tPa infusion through peripheral IV (rather than CDT)!!might be as effective & needs less resources. 5 mg tPa IV bolus —> infusion 2 mg/hr for 10 hr (+ Heparin 500 U/H) #PERT #EHJcasereports academic.oup.com/ehjcr/article/…

Challenging (but rewarding) two #Mitraclip cases on last clip day; first secondary MR with severely restricted P2P3 & second with primary MR with P3 prolapse in non-surgical patient.

@Alshehri_MD Thank you; yes we did CT for planning

@karrowni Amazing case !!! do you have a pre-procedure Cardiac CT ?

#coiling of large coronary #fistula from septal branch of LAD to PA with extreme angulations and causing anterior ischemia; supercross microcath & 3 Azur CX coils did the job. #RadialFirst

@fjsawaya @bostonsci This was CLS 3.5, 6Fr

@karrowni @bostonsci What guide are you using?

I have had 3 cases so far with #Synergy #Megatron stent balloon delivery system getting stuck at the tip of the 6 Fr guide and had to pull everything out together; not sure if others are experiencing this?! Mine were all with 4.5 and 5.0 mm stents @bostonsci #RadialFirst