Dr Suleman

Fellow Structural Heart Disease TAVR, Mcmaster University

[Dr Suleman @docsuleman]

Proud to be a #PCRPresenter and #PCRLV,
@PCRonline
See you in @PCR London Valves, November 27-29

[Dr Suleman @docsuleman]

@AlainaZameer @WomenAs1 @TCTConference @dr_faraz_ahmed Congrats and great job 👌

[Dr Suleman @docsuleman]

The trial included patients who had clinicaly indicated of CTCA in first place. This cohort usualy has less complex disease. We know they dont get benefit from IVUS anyway. for me it was essentialy CTCA + Angio vs Angio trial. and having more information is always benefecial.

[Giuseppe Biondi-Zoccai @gbiondizoccai]

If CT angiography to guide PCI is non-inferior to IVUS, and several trials have shown that IVUS-guided PCI is not incrementally beneficial, does this mean CT angiography also is not beneficial to guide PCI? https://t.co/mYxK5Q32xs @NEJM

[Epic @HeyEpic]

Integrating with Epic just got easier.

Developers can now connect their agents to open.epic documents, Playbooks, API specs, and more with the new open.epic MCP.

https://t.co/lxWiliNhb4

[Dr Suleman @docsuleman]

@willsuh76 Annulus & Stj height? We have done worst as these are not for favorite for surgeons too. May be PERCEVAL? STJ need to be atleast comparable to annulus for sapien. And for SEV the waist of the valve should be comparible. If it was my case both valve can be simulated in Quantavi.

[Dr Suleman @docsuleman]

Very interesting findings, Dr. Filippo! I've been following your PCCT posts with great interest, particularly the coronary images. Just curious, would it be possible to get a single anonymized high-resolution coronary PCCT DICOM study for academic exploration? I'd love to explore the images firsthand.

[Dr Suleman @docsuleman]

A doctor raises concerns about violence, and somehow you turn it into an attack on Pakistani doctors? Many of us left successful careers because of instability, not because we couldn't pass exams. I did too. Starting over as a resident after years as a specialist is a different matter. There's no shame in driving a truck or running a store either. You can disagree without putting others down. A little respect goes a long way.

[Dr Suleman @docsuleman]

The TAVI procedure doesn't always follow the plan. So why should the plan stay the same?

We spend hours planning a TAVI procedure. Valve sizing, coronary risk, deployment depth, working angles, and predicted expansion.

But things change inside the cath lab.

The valve may land deeper than intended. There may be some tilt, incomplete frame expansion, or residual PVL.

These changes can affect coronary risk, valve hemodynamics, and future treatment options.

What if the plan could evolve as the procedure unfolds?

That's why we built TAVIAssist, an AI-powered, voice-controlled assistant integrated with QuanTAVI.

Just ask:

🎙️ "Scroll from the STJ to the annulus."
The CT moves through the aortic root.
🎙️ "Where's the biggest calcium?"
It identifies the location and takes you there.

🎙️ "How do I remove the parallax?"
It provides the C-arm angles from the double S-curve.
🎙️ "If I deploy a 23 at 4 mm, what's my VTC?"
It calculates the coronary distances for that scenario.

🎙️ "Show me the expansion."
It reconstructs the deployed valve frame in 3D from two fluoroscopic views.
No keyboard. No mouse. Just talk to your plan.

This isn't about replacing the operator's judgment. It's about connecting pre-procedural planning with what actually happens during the intervention.
The TAVI plan should not stop at the cath lab door. It should evolve inside the cath lab.

QuanTAVI by Sphygma. Built by operators, for operators.
Watch TAVIAssist in action below.

Research use only. Not FDA cleared for clinical diagnostic use.

#TAVI #TAVR #StructuralHeart #MedTech #CardiacCT

[Dr Suleman @docsuleman]

Most TAVI plans are still made by someone other than the operator who implants the valve.

We're building QuanTAVI at Sphygma to change that: CT-based planning for aortic valve procedures, designed by the cardiologists and surgeons who run these cases.

From the CT to the cath lab:

→ Automatic aortic root measurements, each one reviewable on the images
→ Every valve compared side by side, with the reasons behind each size
→ Instant simulation of the deployed valve: coronary obstruction, root rupture and conduction risk, before the lab
→ Physics-based (FEA) prediction of how the frame will expand
→ Lifetime planning: choose today's valve so the next TAVR stays possible
→ TAVIAssist on the table: working views, valve overlay on fluoro, and the plan by voice
→ Expansion review after deployment: the frame traced on fluoro and rebuilt in 3D

TAVR, SAVR and valve-in-valve on one platform. Built by operators, for operators.

Research use only. Not FDA cleared for clinical diagnostic use.

#TAVI #TAVR #StructuralHeart #CardiacCT

[Warkaa @warkaa21]

Pleased to share our new opinion piece in Structural Heart:

“Lifetime Planning of Aortic Stenosis Treatment Starts Before the First Valve.”

As TAVR expands to younger patients with longer life expectancy, procedural success is no longer enough.

The first valve should preserve the next option.

We propose moving CT upstream in decision-making — from a procedural sizing tool to a lifetime planning tool, considering coronary access, redo-TAVR feasibility, valve platform, implant depth, commissural orientation and frame expansion.

The question is not only: “Can we do TAVR?”
It is: “What will this first intervention allow us to do next?”

#TAVR #TAVI #StructuralHeart #Cardiology #CardiacCT #LifetimeManagement

@GilbertTangMD @mmamas1973 @nolanjimradial @jorgeachv @docsuleman @dr_benoy_n_shah

[Dr Suleman @docsuleman]

@dr_faraz_ahmed Thanks faraz

[Dr Suleman @docsuleman]

Today marks the publication of our ABC sizing app validation study. This multicenter study demonstrates that meticulous sizing, utilizing the ABC algorithm, can significantly mitigate the risk of catastrophic root rupture complications in balloon-expandable valves. The app is available on app store for download.

[CircInterventions @CircIntv]

Can Aortic Root Rupture be averted in bicuspid valve anatomy? ABC Sizing Algorithm for Bicuspid Valves Treated with SAPIEN 3. Presented at @TCTConference #NYValves2026 and published simultaneously @docsuleman https://t.co/qJ1QbsTLVQ

[Dr Suleman @docsuleman]

@JakeFleshner OS for heart procedures.
https://t.co/WfJBHRVDL7

[Dr Suleman @docsuleman]

@Cappy_Nate Followed

[Dr Suleman @docsuleman]

Building QuanTAVI, a software that turns heart CT scans into clear decisions for heart valve procedures (which valve to use, risks, and future planning).

I’m a heart specialist who also builds software, so I understand both the clinical problem and how to solve it.

Edge:

Real doctor + builder (used in real patient workflows, not just a demo)
Helps doctors make decisions, not just measurements (unlike competitors)
Focus on long-term planning for patients, not just one procedure (big shift happening now)

Early stage, looking to scale globally.

[Dr Suleman @docsuleman]

If post-dilating of Evolt is being blamed for 6–7 year failure, maybe we should ask whether the valve remembers crimping - arguably the most aggressive moment of its life 😅

[Dr Suleman @docsuleman]

@GilbertTangMD @JACCJournals Very insightful take.
Vendor-independent TAVR selection matters in low-risk patients who will outlive their first valve, an anatomy-driven (not just risk-driven) approach that prioritizes repeatability should guide the first implant. Working on a structured solution - more soon.

[Dr Suleman @docsuleman]

@JibbyD @remitly Wise

[Dr Suleman @docsuleman]

@realarainmd @Hragy Would love to see your novel approach!
How do you ensure your gantry rotation is truly orthogonal to CTO?
Our app’s first two modules aim to generate a true orthogonal artery view from fluoro lines—though the math is still experimental.

[Dr Suleman @docsuleman]

@realarainmd @Hragy Thanks 🙏. Yes i wanna work on traning AI on ivus images to detect wire and then show a 3d rendered image of wire location just like OCT does. I wanted dicuss that in our meeting that day. Currently im about to finish AI TAVR analysis software and then will need your help on this