Ricardo Garcia De la Peña

Interventional Cardiologist in Monterrey México. CathLab Chief at H. Angeles Valle Oriente.

[Ricardo Garcia De la Peña @RicardioGP]

El Programa de cirugía de revascularizacion coronaria híbrida Robótica (único en México) es un éxito gracias al trabajo en equipo de grandes profesionales unidos por el bien de nuestros pacientes.

[Ricardo Garcia De la Peña @RicardioGP]

Advancing in the understanding of the so complex but also thrilling field of atherosclerotic heart disease and vulnerable plaques in Mexico!

https://t.co/Yh8ybA1mpz

[Ricardo Garcia De la Peña @RicardioGP]

@sbrugaletta Totally agree! We are only just beginning to understand all the influencing factors; there is still much to discover! Hope to see you there! 🫡

[Ricardo Garcia De la Peña @RicardioGP]

@sbrugaletta In highly selected patients I believe there could be arguments that justify it. Rather, I'm asking the opposite: Would you be comfortable leaving an angiographically significant proximal LAD but FFR - with a PB of 70%, a maxLCBI4mm of 700, and MLA of 4 mm²? So hot topics!

[Ricardo Garcia De la Peña @RicardioGP]

63 yo rejected to Cabg, and ALSO rejected to PCI in public hospital (left to fate),CCS IV despite max meds. Very low budget (thnks to LDS church donation to patient).LM-LAD 3 stents and 1 stent to RC ostial CTO (w/microchannels).Will see the Cx in future. Hope improvement in QOL!

[Ricardo Garcia De la Peña @RicardioGP]

@GreggWStone Of course! Not only Renovate. When IVI guided PCI vs CABG: EXCEL: Mace 11.5% vs 14.7% and TVR/TLR 7.9 vs 7.5%. NOBLE: Mace 18.9 vs 19 and TVR/TLR 5.1 vs 10%, PRECOMBAT: Mace 5.7 vs 7.9 and TVR/TLR 11.4 vs 8%. IVI should be mandatory in complex cases and w/that reach CABG results

[Ricardo Garcia De la Peña @RicardioGP]

Severe ostial calcification at ostial LAD, also severe lesion at Cx and moderate at LM. Pt rejected Qx. Shockwave and DK Culotte made the job 👌

[Ricardo Garcia De la Peña @RicardioGP]

Final result

[Ricardo Garcia De la Peña @RicardioGP]

Angina on minimal effort, high burden ischemia on stress echo. Previous LAD Stemi 5 months ago. RC CTO with blunt prox. cap, diffuse disease, and a branch just next the prox cap., also calcification in the CTO...we had some fun yesterday....

[Ricardo Garcia De la Peña @RicardioGP]

Initial pic....3 hours later....final result after Ivus guided stenting...

[Ricardo Garcia De la Peña @RicardioGP]

Pt with ACS on LAD 1 month ago, persistent angina. Today PCI to RC CTO. AWE was enough and the result was great!

[Ricardo Garcia De la Peña @RicardioGP]

Felíz de haber hecho grandes amigos en mi visita a El Salvador, gracias por la invitación para realizar el 1er caso con IVUS-NIRS Makoto en el país! Felicidades a todo el equipo, los esperamos en México! @Nipro_group @Nipro_Mexico @NiproSv

[Ricardo Garcia De la Peña @RicardioGP]

@Hragy @Drlipid More info needed (weight, type of diet e.g low carbs) but surely low Apob, pattern A LDL, Low small LDL, high big LDL, low Lpa. If no insulin resistance my take w'd be that she's good to go wo drugs and if patient (or fam) is worried about it would offer 1/y carotid IMT screening

[Ricardo Garcia De la Peña @RicardioGP]

@AndrewFoy82 @drjohnm @CommunityNotes @DavidLBrownMD @RFRedberg @bogdienache My comment goes more towards not judging a clinical decision based on a single photo and a post from a patient...

[Ricardo Garcia De la Peña @RicardioGP]

Angina+High ischemia burden in strest echo.RC #CTO with some microchannels in AngioCT (not so visible in cathlab).AWE with Fielder XT-R and Turnpike Lp, success true-true lumen but micro didn't cross.Predil with 🎈0.75 and 1.0 the prox cap, after that the case was straightforward