#Cardiology emogies 🎈 balloon 💋🎈kissing balloon ⛓stent 🔦echo 🔞low EF 🔪CABG 💊OMT 🚰diuretics 🚱renal shutdown 💉 Thrombolysis 💔MI 🐲surgeon

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"Effective immediately, the clinical practice of CTO PCI should change based on these results. CTO PCI may require 2 procedures to ensure an optimal outcome in terms of both safety and efficacy, to avoid higher-risk strategies during the initial procedure" https://t.co/ViopP3Hyb8

Years of wearing 11 kg of lead takes a physical toll most PCI operators never talk about. In this short clip, Prof. @bobfostermd reflects on a career spent working under lead. This isn’t a technical lecture. It’s a human account of what long-term protection really demands. If

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🗞️ Hot off the press: #STAR trial First randomized controlled trial comparing two different technical strategies in #CTO #PCI https://t.co/ufJNmNbO2e

She should have considered a medical field like trauma surgery, interventional cardiology etc

At some point a hospital administrator genuinely decided the right call was this: better to make the neurosurgeon stare at a spinning Epic wheel for a couple minutes, then fight through another round of clicks to enter a case request, while the patient blows a pupil, rather

If the aim is to make a million(s) medicine is not the field. I am not being self-righteous. Consider years of education, training and work hours. Follow by dealing with Certifications, Admin Suits, Insurance and Quality Karens.

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Under appreciated by many: in some hospital systems, the procedural cardiologists are the most conservative. Most aggressive can be the referral docs.

A New (Kind Of) STAR Is Born! 48 year old woman with prior IWMI (@ age 36!) → Class II angina on OMT. Stress abnormal in the RCA distribution. CAG revealed RCA IS-CTO. Partner attempted #HDR unsuccessfully, and we ended up doing STAR + CB investment. What to do next?

Last year I was in a grueling discussion against TAVI for an asymptomatic 75 Y patient with moderate AS, AVA 1.2cm sq, mean gradient below 40, normal EF. I lost the argument, patient had TAVI,we are now treating for Coxiella Burnetii TAVI endocarditis, it is endemic in Egypt.

#CTO #TDADR How to do coregistration between Angio and IVUS. How to understand 3D image during #TDADR. Please check A Simple Approach for 3D IVUS‐Angiographic Co‐Registration for CTOs Using the “Be‐The‐Wire” Cognitive Model - Putra - Catheterization and Cardiovascular

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Shockwave balloon trying to navigate the valley between two rocks and fails. #rotaregret

Dissection vs. Dissection All dissections are not the same. Some can be left alone to heal over time, while others demand more immediate attention. IVUS and OCT can reveal important features not seen by angio. How would you treat each of the lesions seen after CBA in a LCX?

There is calcium and there is calcium. Double nodules in series.

@djc795 @jedicath @mmamas1973 @realarainmd @PCRonline @sbrugaletta Agree, a lot to be learned, but let me reframe our questions: 1) Which dissection is ready for #DCB? 2) Which dissection needs additional treatment? a) Further lesion preparation b) #DES

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@jedicath @mmamas1973 @realarainmd @PCRonline @sbrugaletta @stefan_harb From my perspective, the most important question in the immediate term is to understand based on imaging which dissections really need to be stented. We have a good understanding of which residual dissections need stenting after DES, but not during DCB.

End result DES

What is the threshold for accepting dissections for DCB. Planned DCB for distal lesion. Long B dissections on IVUS. @mmamas1973 @realarainmd @PCRonline @sbrugaletta

In Praise Of - The Long View! I use IVI for the vast majority of my cases, and I rely heavily upon the long view. IMHO, the long view is just as essential as the angio. Perhaps better. 🤔 Here is a recent IVUS guided LAD PCI using the long view. Comments to follow.

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@djc795 @Hragy @realarainmd @NishithChandra @aspergian1 @skat_ct