ZeroTLR

Critical view of interventional devices & techniques, let’s keep patients first. Tweets are on my own personal opinion and not medical advice.

[Dr. Gilbert Tang @GilbertTangMD]

#TRILUMINATE #TEER #TriClip RCT @ACCinTouch #ACC2023 late breaker by @psorajja
No diff vs GDMT in ☠️🏩but ⬆️KCCQ ⬇️TR at 1y. Pts DO feel better! Honored to be in this trial and my 1st paper @NEJM! @hahn_rt @caresans26 @SachinGoelMD @mirvatalasnag @KHERA_MD @ParasuramMD

[Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 @AlkashkariWail]

85y♂️ NSTEMI, 5y ago had TAVI in embolized TAVI during same procedure.
Today, PCI to RCA & angiogram to LM done (LAD non-viable). 5Fr RJC advanced over wire between the valves and aortic wall. Spacious STJ was helpful.

[Jonathan Schwartz, MD @jgschwartzmd]

#CRT2023 @CathElectroSurg on multivariate prediction model for coronary obstruction in native & ViV #TAVR —

✅ measure cusp ht:coronary ht/sinus ht
✅ measure VTC / VTSTJ (<4mm = ⬆️risk)
✅ measure leaflet calcium volume (>600mm3 = ⬆️risk)

➡️ sig improved sens/spec
@CRT_meeting

[MIЯVΛƬ #IC ༄ ｡° @mirvatalasnag]

#CRT2023
PCI vs CABG for LM dz w & w/out DM
25% DM

DM pts more likely to have higher Syntax & co-morbidities

PEP: all cause ☠️

SEP: CVS & non-CVS ☠️,stroke, peri-procedural & spontaneous MI

No difference in PEP btwn revasc strategy
⬆️ spontaneous MI & repeat revasc w PCI

[Joshua Goldberg @GoldbergJBCTMD]

Hypoattenuated Leaflet Thickening (HALT)

Operative view of Sapien 3 implanted 6 months prior with #HALT of right and noncoronary leaflet.
#TAVR

[Ritu Thamman MD @iamritu]

@JoaoLCavalcante #CRT23
Bicuspid Anatomy for TAVR
The more calcification raphe leaflet LVOT worse mortality
Shorter membranous septal length in BAV
High LV-Ao angle >60 deg
Concomitant coronary anomalies & coronary heights
#Imaging 🔑 to BAV pt selection for TAVR

[Davide Capodanno @DFCapodanno]

Current hs-cTn assays are highly valuable for rule-out of AMI. This comes at the price of specificity, unless serial assessments are made. However, serial testing does not differentiate Type 1 from Type 2 AMI and, therefore, robust clinical assessment remains crucial. #CRT2023

[Jaffar Khan @CathElectroSurg]

First-in-human TELLTALE-BASILICA @StFrancis_LI! TELLTALE is the first and only dedicated system for transcatheter electrosurgical leaflet modification. Life is so much easier with dedicated devices - BASILICA took only a few minutes and the patient did great! Details at #crt2023

[Andrea Scotti @AndreaScotti21]

✨Glad to share at #CRT2023 our @MonteHeart experience on Prophylactic IABP in TF-TAVI

🌐Out now @EuroInterventio: https://t.co/RD7iJpi7yC

@azeemlatib @jgranadacrf @m_assafin @leoneppmd @MatteoMSturla @CurioJonathan @SebLudwig1 @SpringMD
@MontefioreNYC @EinsteinMed @crfheart

[Dr. Gilbert Tang @GilbertTangMD]

Amazing #ValvePPM app by @bapat_savrtavr @hahn_rt @PPibarot on avoiding PPM and check valve function with ref EOA in AVR MVR #TAVR. Must download now to benefit your pts! @JoaoLCavalcante @mirvatalasnag @PCRonline @crfheart @igeorge1975 @AATSHQ @STS_CTsurgery @EACTS @escardio

[Akiva Rosenzveig @AkivaRosenzveig]

1/Excited to share our recent @ccijournal publication on the incidence & distribution of missed paravalvular regurgitation (PVR) led by Dr. Syed Zaid @AhmedHaniyehMD & @MalikMD10
& huge thanks to @hasan_ahmadMD @GoldbergJBCTMD @GilbertTangMD

🔗https://t.co/fKfPsHP4AV

A 🧵...

[Dr. Gilbert Tang @GilbertTangMD]

Don’t miss @NytvL today #NewYork Transcatheter Valve. World class speakers, 6 live #TAVR #TEER #TMVR cases! @MountSinaiHeart @MountSinaiNYC @IcahnMountSinai @DrSaminSharma @DoctorKini @Drroxmehran @georgedangas @KHERA_MD @ParasuramMD @StamLerakis @DrDavidReich @BethOliverVP

[EuroIntervention @EuroInterventio]

In this multicentre, propensity-matched comparison of the self-expanding ACURATE neo2 and the balloon-expandable SAPIEN 3 Ultra prostheses, the authors found comparably good short-term outcomes but some differences in device success and paravalvular leak. https://t.co/08hMSiea3J

[Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 @AlkashkariWail]

80y♂️ severe AS heavily ca EF35%,
RBBB, LAD prox-mid 90% calcified lesion. PCI to LAD then #TAVR with #evolute_29. Pre&post🎈. #commisural_alignment #cusp_overlap. shallow implant. No ECG↔️,PG3, NO AI. Easy coronary re-access.
@mirvatalasnag @ZeroTLR @rashaalbawardy @DrAlsaiediAB

[Dr. Gilbert Tang @GilbertTangMD]

Honored to present at #HongKongValves2022 alongside a great lineup of speakers. Hope to go back to my birthplace next year in person! #TAVR #FixTR #TMVR @bapat_savrtavr @TsuyoshiKaneko1 @vonBardelebenRS @CathElectroSurg @m_taramasso @hahn_rt @mirvatalasnag @azeemlatib

[ZeroTLR @ZeroTLR]

@BaoGTran @CirujaBarbosa @EACTS @JACCJournals @Pooh_Velagapudi @heartsurgeryuk @SusheelKodaliMD “only 51% of patients met all inclusion and exclusion criteria of the PARTNER 3 (The Safety and Effectiveness of the SAPIEN 3 Transcatheter Heart Valve in Low-Risk Patients w Aortic Stenosis) trial (3) & 41% had a clinical variable that was excluded from TAVR v SAVR trials”

[ZeroTLR @ZeroTLR]

@BaoGTran @CirujaBarbosa @EACTS But just take a look of both LR trials and the exclusion criteria ( cherry 🍒 picking?) , they don’t reflect regular clinical practice #TAVR /#SAVR

Recommend lecture: @jaccjournals https://t.co/Gq7L00yiuv

@Pooh_Velagapudi @heartsurgeryuk @SusheelKodaliMD

[ZeroTLR @ZeroTLR]

@anvoramd @Abiomed Patients will ask Cardiologist about that “thing” for their case, because it will improve their survival rates as the different stories published reflect, in the same way they ask for other devices/ techniques/technologies.

Take a look👀:
https://t.co/ISokwinw2u

[Jaffar Khan @CathElectroSurg]

@GilbertTangMD @TCTConference @NEJM @Drroxmehran @georgedangas @djc795 @mirvatalasnag @SachinGoelMD @PPibarot @lamelaspablo @TCTMD @KendraGrubb @PK_parasu @KHERA_MD @RodrigoBagur @JasonFoerst NEGATIVE trial. Therefore subgroups are hypothesis generating at best.

Second, no correction made for statistical chance so only point estimates for the many subgroups given in NEJM.

Presentations and ads don’t undergo the same rigour, unfortunately, so a p value has snuck in.

[Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 @AlkashkariWail]

84y♀️ sever AS, perim 62,area 300, SOV 26.6, LM 6.8. #lifetime_management #TAVR @Medtronic #evolute 23mm #cusp_overlap #commisural_alignment
MPG 4, No AI, no ECG change
@DrAlsaiediAB @MogneeA @rashaalbawardy @bogamisa @AlrahimiJ @TAVRBot @mirvatalasnag @GilbertTangMD @colum_owens