Top Tweets for #Commissural_alignment
@AlkashkariWail Totally agree @AlkashkariWail #Commissural_alignment is very important technique to be done with any SEV as shown useful in this case
But sometimes we do the opposite depending on how big (small)the aortic arch & asc aorta
In this patient judk 4 used for 26mm bz wide aortic arch.
It's important to practice coronary access now to overcome the future obstacles & to challenge the concept of #Commissural_alignment
Two Cases of TAVR #evoluteR 26mm with #cusp_overlap (both end with SR with no ECG 🔄)& #Commissural_alignment (both with easy coronary access)done with my young talented implanter Colleagues @DrAlsaiediAB @rashaalbawardy
We usually use L Judk 3.5 for 23&26mm & LJ 4 for 29 & 34mm
Great discussion and excellent live case presented at #EuroPCR PCR about #TAVR in a patient with CAD at risk of coronary reintervention using ACURATE neo™ system demonstrating #commissural_alignment
facilitating easier coronary access in future
#EuroPCR @PCRonline @TAVRBot
@AbosalemElsayed @md_SsAhmad @rahilraf @Almanfi_Cardio @Subbu_boppana @Babar_Basir @chadialraies @evandrofilhobr @caresans26 @heartdoc45 @erichorlick The solution for that is to use #Commissural_alignment
It will make your life easier.
76y♂️ severe AS, ca+++, BAV type 1b, EF25%,LBBB. presented to other hospital Cardi shock,🎈valvoplasty done to stabilize him complicated by stroke with minimal residual deficit. Today TAVR #Commissural_alignment #cusp_overlap #CPD #evolutepro29 Excellent result MG5, LBBB, NO PVL.
@Hragy @Almanfi_Cardio @mirvatalasnag @GilbertTangMD @GuiAttizzaniMD @ZeroTLR @TAVRBot @colum_owens @jedicath @rashaalbawardy @bogamisa @DrAlsaiediAB @lamelaspablo @MogneeA @adnanalkhouli @fjsawaya @evandrofilhobr @ElhayekMD @karrowni I agree with him...i took me> 350 cases to be comfortable in implanting high and the #cusp_overlap tech made it much easy.. You have to believe in #cusp_overlap & #Commissural_alignment to have good results.
@GilbertTangMD
@mirvatalasnag @GilbertTangMD @GuiAttizzaniMD @Almanfi_Cardio @ZeroTLR @TAVRBot @colum_owens @jedicath @rashaalbawardy @bogamisa @DrAlsaiediAB @lamelaspablo @Hragy @MogneeA @adnanalkhouli @fjsawaya @evandrofilhobr @ElhayekMD @karrowni The benefits of high implantation is single digit risk of PPM.Coronary access is not an issue with #Commissural_alignment. We are accessing every coronary after TAVR. I believe in addition to #Com_align we need to do extra exercises to find the best way to manipulate the catheter
My trip to Kansas today to help & proctor the #TAVR team at @SalinaRegional Health Center.
2 great cases with #Commissural_alignment #Cusp_Overlap & #LAO_depth_assessment Great team work & awesome results. @d7battin it was nice working with you & your team 👏
@MDT_StructHeart
@GilbertTangMD @Kabirjt @jwhansen1983 @adnanalkhouli @Almanfi_Cardio @HarshGMD @mirvatalasnag @rational_doc @VikasBhallaMD @rajivxgulati @heartdoc45 @omendiz Will do.. I will submit this case for them. I should say that we are doing very good with coronary access with #evolute based on #Commissural_alignment.. It's your work and your colleagues.. You should be very proud. All towards the benefit of our precious patients.
Before complete deployment, LM angio>good flow, parked stent removed. Excellent result trace PVL, MPG5 with #pro_tech #cusp_overlap (no ECG chang) #Commissural_alignment coronary re-access(IVUS revealed good LM Stent apposi)
Few years ago,proctoring new TAVR centers where focused on how to deploy the #evolute &leave the room,w/out #cusp_overlap #Commissural_alignment. Now it's totally different with these 2 techniques. Most of the new implanter now do it easily with low PPM & Coronary re-access. eg👇
@fjsawaya @AhmadAlkhalilMD @adnanalkhouli @GilbertTangMD @RonnieRamadan @mirvatalasnag @drdevireddy @ibarb_ @AkramWIbrahim I will accept mild PVL on the expense of avoiding other serious complications (rupture, fistula ect)..
NB: I will thrive to do good #Commissural_alignment bz the diseased CA to ensure coronary access in the future.
82y♀️severe AS, evolutR 26mm #cusp_overlap & #Commissural_alignment with CA at the end of TAVR, MPG6, ECG no chsnges
#cusp_overlap & #Commissural_alignment is game changer,should be attempted in any anatomy:
78y♂️severe functional BAV(1a,L-R),area524, LM6.6m,SOV33, horizontal aorta (annular ang>70), #evoluteR 34 (landerquist) #cusp_overlap #Commissural_alignment (with CA)
MPG 3,ECG SR.
77 Y/O male with severe sympt. #AS NYHC IV, mPG 49 mmhg AVA 1.0 cm underwent successful #TAVR with #evoluteR 29 using #cusp_overlap technique & achieving optimal #Commissural_alignment and excellent final results
(MPG 4.9mmhg, no PVL,no Ecg)
skin to skin time 30 min
@ksmcmedia
@mirvatalasnag @adnanalkhouli @Almanfi_Cardio @fjsawaya @colum_owens @BElbarouni @Obisht @StructuralBCN @MBalghith @6ayyeboon @didier_tchetche @mmamas1973 @rashaalbawardy @evandrofilhobr Most of the published data didn't include patient with #Commissural_alignment in their studies..
It would be very interesting to have a studies looking specifically for coronary access with such tech.
I am quite sure you see alot of encouraging data soon.
@6ayyeboon @mirvatalasnag @Almanfi_Cardio @fjsawaya @colum_owens @BElbarouni @Obisht @adnanalkhouli @StructuralBCN @MBalghith @didier_tchetche @mmamas1973 @rashaalbawardy @evandrofilhobr We are testing and proving the #Commissural_alignment concept this is why I do CA routinely
@mirvatalasnag @Almanfi_Cardio @fjsawaya @colum_owens @BElbarouni @Obisht @adnanalkhouli @StructuralBCN @MBalghith @6ayyeboon @didier_tchetche @mmamas1973 @rashaalbawardy @evandrofilhobr It's non-selective bz we didn't tried further.. But Once I made sure there is #Commissural_alignment it's easy to engage selectively 🤠
80y♀️severe AS
#evoluteR 26 with #cusp_overlap & #Commissural_alignment
PG4, no PVL, no ECG🔄.
Currently we do routine CA for each case to ensure coronary accessibility with adoption of #Commissural_alignment
Anybody do the same?
@GilbertTangMD @ZeroTLR @TAVRBot @GuiAttizzaniMD
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