Isaac Tea

Saving lives 81mg at a time. Interventional Cardiologist by day & night. HF & cardiogenic shock passionate. #RadialFirst but also #SafeFemoral. PGY-Forever 🦾.

[John Mandrola, MD @drjohnm]

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

[Jimmy Kerrigan @kerrigjl]

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…

[Isaac Tea @IceTeaMD]

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

[IMCrit @IM_Crit_]

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
https://t.co/ZnHdRHIRSm

[Murmur MD @Murmur_MD]

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

[Murmur MD @Murmur_MD]

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

[Isaac Tea @IceTeaMD]

@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%.

[Isaac Tea @IceTeaMD]

@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.

[jedicath աǟզǟʀ.ǟɦʍɛɖ @jedicath]

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

[Mustafa Ahmed @MustafaAhmedMD]

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

[Alexander Mladenow MD @alex1708ander]

#echofirst shows how surgical TEE view for MV-PPL (peri prosthetic leaks) localization corresponds to interventionalist’s view on fluoroscopy #CardioTwitter
https://t.co/EM0t76aCFP

[Khurram Nasir @khurramn1]

Almost all scores/biomarkers approaches in the contemporary era over predict CV risk

Time to pivot for a more accurate decision aid
#CacTesting #SeeDiseaseTreatDisease

[Isaac Tea @IceTeaMD]

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

[Robert W. Yeh @rwyeh]

Astonishing results from the DanGer Shock Trial presented at #ACC24 and out in @NEJM today.

In patients with ST-elevation MI with cardiogenic shock, Impella reduced all-cause mortality (45.8% Impella vs. 58.5% control) at 180 days.

Some thoughts on this ground breaking trial:

[EuroIntervention @EuroInterventio]

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. https://t.co/wAbuEH0V2m

Editorial by @ThomPilgrim ; Annette Maznyczka https://t.co/7t3rGCVGdO

[IMCrit @IM_Crit_]

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:

[Isaac Tea @IceTeaMD]

See also:
IVUS-guided vs coronary angiography-guided PCI in patients with AMI: A systematic review and meta-analysis
https://t.co/QGzj9xtuLS

IVUS–Guided or Angiography-Guided Complex PCI
https://t.co/5a4E8bchLD

[Isaac Tea @IceTeaMD]

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!

[Isaac Tea @IceTeaMD]

Image courtesy of Xia et. al - IVUS Image Segmentation Using Superpixel-Wise Fuzzy Clustering and Level Set Evolution
https://t.co/LMW9vanISt

[Ju Kim @JuKimMD]

Fantastic @HMethodistCV Grand Rounds by @RyanTedfordMD on RV reserve. Watch here: https://t.co/Pcx3gBFeIo.

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 https://t.co/JxrTm2ytGU

[Shariq Shamim @ShariqShamimMD]

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