Isaac Tea

No trial better explains the importance of evidence than REVIVED BCIS. It boggles my mind that it was negative @divaka_perera is correct, but try telling 99% of American cardiologists We still cath new LV dys pts TO FIND LESIONS TO REVASC despite negative trials #ESC2025

Question for those who have adopted bival for STEMI: do you do two hours or four hours after PCI for the infusion? Do you try to wean the radial band while it is running or just wait until it is done? Trying to build an order set…

@jedicath @EM_RESUS @TheEKGGuy @Toaster_Pastry Can we see the angios? This is an interesting case. Thank you!

@EM_RESUS @TheEKGGuy @Toaster_Pastry Didn’t expect a non dominant RCA to lead to extensive STE while a huge dominant LCX PDa was normal.

Cath lab activated. Which artery was the culprit (I was surprised). FYI I never remember the criteria @TheEKGGuy @EM_RESUS @Toaster_Pastry

ICU (Central Venous/Arterial) Line Secrets - Part 2: Following from where I stopped last week (that's why I keep same numbering) & without hoping to a provide tutorial about how to place lines, there are some additional points that I find worth mentioning x.com/IM_Crit_/statu…

Quick tips from @jason_wollmuth on Single Access dry closure! #CardioTwitter #MCS

Dr. Jason Wollmuth gives a step-by-step guide on his Sideclose Technique! #CardioTwitter #MCS

@SachinGoelMD @adnanalkhouli Although mortality and patient risk profiles for TAVR have decreased over the years, the periprocedural stroke rate has remained consistent, around 2–2.5%.

@SachinGoelMD @adnanalkhouli Hi Dr. Goel! Had something similar. For sure protects intra procedure, with careful manipulation of Safari...and luck. Problem is device does not stay in post procedure. We got away with it here. But the few unfortunate post TAVR strokes have all been ~12 hours post procedure.

📍Embolic Protection in TAVR back in the spotlight 🆕 TVT registry 📝 shows that CEP is associated w ⬇️⬇️ in disability stroke This was not shown in PROTECTED TAVR. Was the trial underpowered or are the surrogates used in this OBS study less granular? ahajournals.org/doi/abs/10.116…

DCB have been available for 14 years in Europe and elsewhere outside USA. As US IC are excited for DCBs, note the results with POBA were not always perfect. We don't know the role of DCBs in setting of dissections and recoil. Diffusel disease in LAD and didn't want a FMJ so treated with DCB, before & after DCB 1/3 @mmamas1973 @djc795 @DocSavageTJU @rwyeh @Babar_Basir @SripalBangalore @Umair2017

I use Echonav for helping trainees understand the interplay between echo and fluoro through live real time fusion of modalities. Features allow for more intuitive instruction and understanding. Also the imagery is outstanding. Here's one of our examples. #UABStructural

#echofirst shows how surgical TEE view for MV-PPL (peri prosthetic leaks) localization corresponds to interventionalist’s view on fluoroscopy #CardioTwitter doi.org/10.1016/j.jcin…

Almost all scores/biomarkers approaches in the contemporary era over predict CV risk Time to pivot for a more accurate decision aid #CacTesting #SeeDiseaseTreatDisease

Amazing work from the DanGer investigators!!! Finally, an RCT for AMI-CS for an MCS device with a psotive outcome for Impella. A new era. Validates our efforts in the trenches to save these patients on death's door. 🦾 @Abiomed @CardioNerds @HMHCardioFellow

The TAVI-MultiCLOSE study investigated a new vascular closure algorithm, MultiCLOSE, for arterial access closure after transfemoral TAVI. This stepwise approach involves initial preclosure with suture-based devices, followed by a final closure customized through angiographic control. The study found that the MultiCLOSE algorithm effectively achieved arterial haemostasis with very low rates of vascular complications and mortality. Demonstrating ease of use, safety, and durability, the MultiCLOSE method significantly reduces major vascular complications, marking a promising advancement in post-TAVI patient care. ow.ly/xxbB50QWUhi Editorial by @ThomPilgrim ; Annette Maznyczka ow.ly/u1aW50QZM5V

ICU Nightshift Secrets: This will sound a lot as as cookbook medicine but bear w me. The 2 drugs that I use more than anything else whenever I'm on a nightshift are: furosemide & dexmedetomidine. If u don't use any of them, u are probably missing something Case from last night:

See also: IVUS-guided vs coronary angiography-guided PCI in patients with AMI: A systematic review and meta-analysis pubmed.ncbi.nlm.nih.gov/35041893/ IVUS–Guided or Angiography-Guided Complex PCI nejm.org/doi/10.1056/NE…

Image courtesy of Xia et. al - IVUS Image Segmentation Using Superpixel-Wise Fuzzy Clustering and Level Set Evolution mdpi.com/2076-3417/9/22…

Keep your Thanksgiving Day dinner conversations civil! If uncle Bob thinks that IVUS guided PCI does not improve on all-cause mortality, MACE & TVR in AMI or Complex PCI, calmly redirect the conversation to 1 vs 3 month DAPT or something non controversial. Happy Thanksgiving!

Fantastic @HMethodistCV Grand Rounds by @RyanTedfordMD on RV reserve. Watch here: youtube.com/watch?v=HTyZyo…. Join @DeBakeyCVedu tomorrow at the George P. Noon Heart Failure Symposium to learn more from him and other leaders in the field of #LVAD. Register learn.houstonmethodist.org/gpn-heart-2023

Best bifurcation angles. Several of these can’t be achieved on table though.