Tony Main

Structural/Interventional Cardiologist @HSN_sudbury #TAVI #TAVR #radialfirst #PFO #SCAD Opinions are my own

[EuroIntervention @EuroInterventio]

New issue out today 📣📣
Highlights include:
• A State-of-the-Art review on coronary interventions in patients undergoing TAVI
• Early haemodynamic valve deterioration after TAVI
• 30-day outcomes of redo-TAVI with SAPIEN 3
• First clinical experience with the Unica device for tricuspid regurgitation
• The UNICORN technique in native aortic valves
and more

https://t.co/C7WKy64Say

@A_Trimaille @G_Tarantini01 @npfam1
@Jmparadis27
#TAVI #StructuralHeart #InterventionalCardiology

[Davide Capodanno @DFCapodanno]

This State-of-the-Art review provides a comprehensive and practical overview of coronary interventions related to TAVI, encompassing coronary evaluation and physiological assessment, the indications and timing of percutaneous coronary intervention before and after valve implantation, and strategies for managing coronary obstruction. https://t.co/yojhLj5N5p

[Tony Main @TonyMain6]

@Yoshito_Kadoya Congratulations!

[Angel Caldera @caldera_99]

This a unique case from @BSWHRR_CARD , courtesy of the Master of Tricks @jfcondado + @raulmgmd and nicely put together by our stellar fellow @jonw1n 👏👏👏 details at https://t.co/51nVhklViV🙏🏻😎

[JACC Journals @JACCJournals]

Higher #TAVR device implantation was linked to improved outcomes with similar safety events, including valve migration, across implantation depths. Long-term effects, including redo-TAVR feasibility, need further study. https://t.co/zRRe8TgGVB

#EuroPCR #JACCINT

[EuroIntervention @EuroInterventio]

NEW SIMULTANEOUS PUBLICATION #EuroPCR NOW ONLINE 🔥

Early haemodynamic valve deterioration (HVD) after TAVI was observed in 3.1% of patients in this large multicentre registry and was independently associated with reduced valve-related clinical efficacy, stroke, bioprosthetic valve dysfunction, and valve failure during follow-up.

Read the full paper here🔗 https://t.co/C7WKy64Say

Editorial by @ron_waksman https://t.co/dxKEjhzje3

@A_Trimaille @gveigafernandez @luisnombela @JorgeNuche @franzone_anna @AsmaratsL @AnderRegueiro @MariaDelTrigo @David_delVal_ @PabloAvanzas @MicheleTrichil0 @nicolasmmaneiro @Madda_im @StructuralBCN @ejfu0209 @pjdiazp @pedro_cepas

[JACC Journals @JACCJournals]

BATMAN was assoc w/ high technical success, effectiveness in preventing #LVOT obstruction, & appeared to be safe in ViR & ViV procedures. Adverse events were higher in ViMAC, according to an LBCT presented at #EuroPCR & simultaneously published in #JACCINT https://t.co/hHqTKZ7K1p

[Nieves Gonzalo @NievesGonzalo1]

🔥 #EuroPCR 2026 Major Late-Breaking Trials🔥: 
Long-term mortality following PCI with DES versus CABG for left main disease

An individual participant data meta-analysis of the SYNTAX, PRECOMBAT, NOBLE and EXCEL trials presented by Brian Bergmark showed no significant difference in all-cause mortality between DES PCI and CABG over 10-year follow-up in patients with left main coronary artery disease suitable for revascularisation.

Read the press release here ➡️ https://t.co/rPxXxuumpC

#LeftMain #PCI #CABG #CoronaryArteryDisease #InterventionalCardiology #ClinicalTrials

@PCRonline

[MIЯVΛƬ #IC ༄ ｡° @mirvatalasnag]

@PCRonline #EuroPCR Interesting use of Impella CP across previously implanted @TAVRBot

Catheter is deliverable
Wire bias may require a buddy wire or snared tip

THV function & integrity retained

@thiele_holger @G_Tarantini01 @HRahbi @giuliamasiero3 @drptca @Babar_Basir

[CardiovascularCorner @TrackYourHeart]

What effects do LBBB, RBBB and LVH with repolarization abnormalities have on exercise stress testing interpretation?

🔴 LBBB → ST changes are unreliable due to abnormal repolarization. False-positive ST depressions may appear in V5-V6, I, aVL. Instead, use nuclear stress imaging or stress echo for accurate assessment.

🔵 RBBB → Less impact than LBBB, but ST-T changes in V1-V3 are not ischemic. Focus on inferolateral leads (V5-V6, II, III, aVF, I, aVL) for valid ischemia detection.

🟢 LVH with repolarization abnormalities → ST depressions & T-wave inversions (strain pattern) are common, especially in lateral leads (I, aVL, V5-V6). These changes often lead to false positives, making imaging crucial for confirmation.

[Amitabh Yaduvanshi MD, DM, FACC, FSCAI @IntervnCardio]

1/9
🚨 𝗟𝗲𝗳𝘁 𝗺𝗮𝗶𝗻 (𝗟𝗠) 𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗮𝗿𝘁𝗲𝗿𝘆 𝗱𝗶𝘀𝗲𝗮𝘀𝗲 is one of the most complex subsets for PCI, carrying a high risk of late complications.
The ultimate game-changer for improving patient outcomes? 𝗜𝗻𝘁𝗿𝗮𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗜𝗺𝗮𝗴𝗶𝗻𝗴 (𝗜𝗖𝗜) .
Here is a breakdown of the new EAPCI & EBC consensus statement. 🧵👇

[Murmur MD @Murmur_MD]

#Toolkit 🔨⚙️Tips!

Transcaval TAVR, step by step: from access to closure.

Dr. Ajay Yadlapati breaks down how he approaches these cases.

For those using transcaval access: what are your go-to tricks for planning, crossing, or closure?

#TAVR #CardioX #StructuralHeart

[Evandro Martins F. MD @evandrofilhobr]

Burr entrapment, one of the most feared complications in rotational atherectomy. Multiple bailouts, choice driven by operator experience. Algorithms help organize the toolbox, especially for less experienced operators. My usual path: step (2) vasodilator + gentle pull (solves most), then (5) wire + balloon next to the burr or (6) knuckle wire for the resistant ones. With step (3), skipping rope, a newer iterative technique, I'll probably start following this more logical sequence.
#CHIP #Rotablator #RA #atherectomy #entrapment

[Lorenzo Azzalini @LAzzaliniMD]

Coronary slow flow is not diagnostic of microvascular dysfunction in patients with angina and unobstructed coronary arteries.
Coronary physiology interrogation has debunked one of the fallacies of the last decades.

[Tony Main @TonyMain6]

@adrianocaixeta Beautiful final result

[Tony Main @TonyMain6]

@DrBIqbal @TurinCTO_CHIP Congrats Bilal!

[Tony Main @TonyMain6]

@SubodhVermaMD Congratulations Danny

[PCRonline 🫀 @PCRonline]

New Journal Club review: NOBLE 10-year outcomes of PCI vs CABG in left main disease

🔗https://t.co/BVu92fFLuv

Long-term evidence comparing PCI and CABG for unprotected left main coronary disease has been limited and sometimes conflicting. The 10-year results from the NOBLE trial now provide important clarity on all-cause mortality outcomes with both revascularisation strategies.

Read this review by @RuxSava

#interventionalcardiology #clinicaltrial #MedX

[Tony Main @TonyMain6]

@Shikha_Cardio @Almanfi_Cardio @JACCJournals Great job!

[Michael Megaly @MichaelMegalyMD]

@realarainmd There is that brilliant technique publish bt @PCRonline
https://t.co/UOG0sfoOT4

I actually did a video at bedside to try it yesterday, I will post it shortly
did you try this @realarainmd