Joseph Walsh

Structural heart interventionalist with Saint Alphonsus Medical Center interested in device development and clinical trial investigation

[Murmur MD @Murmur_MD]

Left atrial appendage closure vs DOAC therapy is often framed as a stroke prevention decision. Dr. @chetanhuded and Dr. Walsh discuss a more nuanced issue: timing of risk.

How do you talk through early procedural risk vs long-term bleeding risk in appendage closure conversations? #CardioX #LAAC

[Murmur MD @Murmur_MD]

Land your SAPIEN perfect every time!

Quick tip from Dr. Joe Walsh. #CardioTwitter #TAVR

[Murmur MD @Murmur_MD]

CHAMPION-AF Explained: Can LAA Closure Beat DOACs?

A deep dive into the CHAMPION-AF data with Dr. Saibal Kar and Dr. Tom Waggoner

Links below! #CardioTwitter #LAAC

[Murmur MD @Murmur_MD]

“Stent thrombosis isn’t a problem- it’s a diagnosis.”

@nyalborgesmd and @joewalshmd discuss Stent Thrombosis Management: IVUS-Guided Strategy and When to Use DCB!

Links below⬇️ #CardioTwitter #Coronary #DCB

[Murmur MD @Murmur_MD]

We had the opportunity to attend @ArchSymposium last week and it was fantastic!

Really exciting to see live cases from around the world, along with complex case discussions from many familiar voices in our community.

Here's a great conversation featuring @JSinghMD and @CMcNeelyMD highlighting:

19 years of ARCH—what’s changed and what hasn’t
The continued evolution of live case education
Where ARCH is headed and the opportunities for physicians.

More cases and insights we recorded to come! #CardioTwitter

[Murmur MD @Murmur_MD]

CT for PCI isn’t just about stenosis.

A highlight from Dr. Karim Al-Azizi’s presentation at #ARCHsymposium on what the IC needs to know from the CT angiography for PCI planning. #CardioTwitter #ARCH2026

[Murmur MD @Murmur_MD]

How aggressive are you with TAVR predilation sizing? And which balloon (NC vs. SC)?

@nfrogge's approch:
Size to mean annulus
Avoid going over the valve waist (even though IFU allows waist +1)
If calcium is modest, we go a little smaller to preserve oversizing (Evolute target ~13–33%) #CardioTwitter

[Murmur MD @Murmur_MD]

“Ostial RCA disease tests every PCI skill.”

Two Layers of Stent in the Ostial RCA: Strategy, Imaging, and PCI Decision Making- a case discussion with @nyalborgesmd and @joewalshmd

Links to the videos below! #CardioTwitter #Coronary

[Murmur MD @Murmur_MD]

A discussion with Dr. Frogge and Dr. Summers on the four key cusp overlap techniques! #COT #CardioTwitter

[Murmur MD @Murmur_MD]

How do you size DCB? IC Treating a 3.0 PDA and 3.5 distal right in this case.

Quick conversation with @nyalborgesmd and Dr. Joe Walsh about reasoning behind sizing. #CardioTwitter

[Murmur MD @Murmur_MD]

Presentation in practice: @amrabbasmd discusses the stigma around 20mm valves, and optimizing valve deployment at @CVISummit! #cardiotwitter #TAVR

[Murmur MD @Murmur_MD]

A great discussion with @DrJayMohan and @Samsayfo on iliac stent delivery challenges.

This was part of a longer masterclass in iliac CTO- IVUS, re-entry, IVL, and stent strategy that can be found in our community! #CardioTwitter #Peripheral

[Murmur MD @Murmur_MD]

“BiPella turned progressive shock into recovery.”

A deep dive into an acute MI shock case, severe right ventricular failure, and how Bipella support stabilized the patient.

Link below!

[Murmur MD @Murmur_MD]

Is oxygenation your main trigger for ECMO, or do other hemodynamic thresholds push you there sooner?

Dr. Chris Brown uses this guide for most cases.
If yes → VA ECMO + LV vent (typically Impella).
If no → Bipella for unloading, easier cath lab workflow, and better patient tolerance

Here’s a recent Bipella case he performed.

[Murmur MD @Murmur_MD]

Interesting case presented by @RajTayalMD at @CVISummit - patient in cardiogenic shock with severe AS. ICE guided atrial septostomy to place on LAVA ECMO.

ASD Closure and good final results. Highlights how the use of MCS allows for procedural optimization. #cardiotwitter

[Murmur MD @Murmur_MD]

"Caging the beast"

A quick look at IVUS direct stent technique from Dr. Brown and Dr. Walsh on a late presenting clot. #CardioTwitter #MCS

[Murmur MD @Murmur_MD]

After walking through a difficult iliac CTO case, @DrJayMohan discussed when you should step back and consider EVAR.

You can see a short from his case discussion with @Samsayfo here! #cardiotwitter #peripheral

Full discussion in our community now!

[Murmur MD @Murmur_MD]

A discussion on the BATMAN technique for TMVR with Dr. @g_giustinoMD and Dr. Andrei Pop.

This was part of a longer discussion and case presentation from Dr. Giustino's recently published case. Link to the full video below! #CardioTwitter #TAVR

[Murmur MD @Murmur_MD]

Great WATCHMAN technique:

Even with good coaxial alignment, a thick Coumadin ridge can distort post-deployment angio.

👉 Take parallax out of the final shot using fluoro markers.

Clean ostial landing, no guesswork.
Simple, reliable tool for the kit.

#CardioTwitter #LAAC

[Murmur MD @Murmur_MD]

Tortuous LIMA. Heavy calcium. Prior failed PCI.

In this session, @TheNarulaSeries breaks down how he managed a brutally difficult LIMA–LAD lesion using:

• ROTA
• Shockwave IVL
• DCB in the distal LAD
• Rapid response to sudden graft thrombus and low ACT

Takeaways: device sequencing, escalation strategy, and staying calm when the graft fills with clot.

A masterclass in complex coronary problem-solving.

Full discussion on MurmurMD and links below:
#ComplexPCI #CardioTwitter