Phillip Rowse, MD, FACS

Cardiac Surgeon - Mayo Clinic, Robotic Enthusiast, Rock Climber, Educator, tweets are my own.

[Phillip Rowse, MD, FACS @RowseMD]

On average, someone in the U.S. dies of a stroke every 3 minutes and 14 seconds. If there is a history of A.Fib, please address the left atrial appendage at the time of cardiac surgery!

[Phillip Rowse, MD, FACS @RowseMD]

@doc_ecmo @LKoliastasis @andreaskardio @KToutouzas Consider etoh septal ablation on table.

[Phillip Rowse, MD, FACS @RowseMD]

@marcelohaertel @JoaoLCavalcante @echo_stepbystep @alexsfelixecho @almasthela @AugustinCoisne @AntonioBarros_ @dr_benoy_n_shah @eromerodorta @NMerke @EchofirstB @kjetilbuer @GE_IanMc @ElenaGalli10 I would worry about cusp thrombosis in the recess of the cusp.

[Phillip Rowse, MD, FACS @RowseMD]

Pericardial thickness…

2 mm = Normal

4 mm = Possible Constriction

6 mm = ⬆️ Specificity Constriction

[Phillip Rowse, MD, FACS @RowseMD]

The Brockenbrough-Braunwald-Morrow sign.

This sign is characterized by a ⬇️ in arterial pulse pressure after a premature ventricular contraction, accompanied by a significant ⬆️ in peak left ventricular systolic pressure.

[Mayo Clinic Cardiac Surgery @MayoClinicCVS]

Cardiac Surgery @MayoClinic is honored to be ranked No.1 in Newsweek's 'World's Best Specialized Hospitals 2024'!
https://t.co/LqFqnKbv2l

[Phillip Rowse, MD, FACS @RowseMD]

@KSABarns @erictammd @KrithikaRamapr1 Agree

[Phillip Rowse, MD, FACS @RowseMD]

Severe constrictive pericarditis. Starting CVP was 25mmHg, CI was 1.77 L/min/m2 and PAP was 51/20. Following near total pericardiectomy CVP dropped to 10 mmHg, CI improved 3.2 L/min/m2, PAP 34/20. @KrithikaRamapr1

[Phillip Rowse, MD, FACS @RowseMD]

@LuisCastroMD @tomcnguyen @JoChikweMD @M_Pompeu_Sa_MD @ovidiogarciav Nice result. In our experience, adequate septal myectomy is usually sufficient to relieve both the dynamic outflow tract obstruction and abolish SAM without the need of mitral valve repair…unless there is an intrinsic mitral valve problem.

[Marci Newcome @MarciNewcome]

Proud to be a part of this great @MayoClinicCVS team!

[Phillip Rowse, MD, FACS @RowseMD]

@DinaSRamini @UAZHeart @UofAZSurgeryRes Very cool….just don’t tell the thoracic surgeons😉

[Phillip Rowse, MD, FACS @RowseMD]

@JohnTreffalls @Mitrovalvology @MayoClinic @MayoSurgery @MayoClinicCVS @beccatreffalls Superb job! Hope you find your way back to Mayo. All best wishes.

[Phillip Rowse, MD, FACS @RowseMD]

One of the most important slides for all CT Fellows to study!!!

[Phillip Rowse, MD, FACS @RowseMD]

It is not uncommon to see a partial or complete LBBB after myectomy. Watch out for a pre-existing RBBB as this carries increased risk of requiring PPM after myectomy.

The asterisks indicates the initial site of myectomy (nadir of the RCC…it is then carried CCW to the AMVL).

[Phillip Rowse, MD, FACS @RowseMD]

Principles of repair:
1. Preserve leaflet mobility
2. Reduce height of PMVL
3. Reduce annular dilatation
4. Restore leaflet coaptation
5. Prevent SAM

[Phillip Rowse, MD, FACS @RowseMD]

When should you advise surgical myectomy for HCM?

1. Effort induced symptoms are unresponsive to medical Rx (beta blockers, calcium channel blockers, disopyramide).

2. Patient is intolerant to medicine (meds make them feel worse).

[Phillip Rowse, MD, FACS @RowseMD]

Severe mitral annular calcification.

How do you manage this when performing MVR?

Debridement with or without patch? Suture around the calcium bar? Suture into the leaflet? Suture to left atrium?

Whatever you can to get a good valve in with no perileak.

[Phillip Rowse, MD, FACS @RowseMD]

Aortic valve regurgitation repair in a Bicuspid valve.

Plicate (or limited resection) to eliminate conjoined cusp redundancy, close the sub-commissural triangles (5 0 Ethibond with Teflon pledgets) and resuspend the commissures.

[Phillip Rowse, MD, FACS @RowseMD]

Ingenuity starts with a simple idea.

[Phillip Rowse, MD, FACS @RowseMD]

Looking at a CTA to assess candidacy for robotic mitral repair.

What’s the abnormality?

[Phillip Rowse, MD, FACS @RowseMD]

Myectomy specimen(s). I use a #10 knife blade with the aortotomy carried very low into the non-coronary sinus…what do you use?