Nathan 🐸 Frogge MD

Interventional & Structural Cardiologist @washumedicine, and (probably) not a chatbot

[Davide Capodanno @DFCapodanno]

Ok, if we now have the BATMAN (Balloon-Assisted Translocation of the Anterior Mitral Valve) and ROBIN (Retrograde Radiofrequency Balloon-Assisted Optimization of Neo-LVOT) techniques, I’ll raise the stakes with:

1. SUPERMAN = Supra-annular Ultrasound-guided Prosthesis Expansion for Reducing Mitral Annular Narrowing

2. WONDER WOMAN = Wire-Oriented Navigation for Dynamic Evaluation of Restricted WOrking Mitral Anatomy in Neo-LVOT

3. FLASH = Frontline Laser-Ablation for Subvalvular Hypertrophy

4. GREEN LANTERN = Guidewire-Referenced Electroanatomical Evaluation for Neo-LVOT Luminal Assessment with Non-invasive Tracking of Endocardial Risk Nodes

5. AQUAMAN = Advanced Quantification of Underlying Aortic Morphology for Alignment in Neovalve positioning

[WashU Medicine Department of Medicine @WashUDeptMed]

Extending congrats to Prashanth D. Thakker, MD, who has been appointed new Program Director for @WashUCardiology Disease Fellowship.

Dr. Thakker is succeeding Dr. Andy Kates who has served admirably in this role for the last 16 years.

Read more > https://t.co/gOfrFsUTSI

[Nathan 🐸 Frogge MD @nfrogge]

@Paddy_Barrett This is a nice image. Where did you get it? Great thread.

[Dr Paddy Barrett @Paddy_Barrett]

Bill Clinton had 8 exercise stress tests when he was in office and 'passed' each of them with flying colours.

He then had a heart test that showed he need coronary artery bypass surgery.

Want to know what test he had?

🧵👇

/1

[Dr Paddy Barrett @Paddy_Barrett]

Bill Clinton had 8 exercise stress tests when he was in office and 'passed' each of them with flying colours.

He then had a heart test that showed he need coronary artery bypass surgery.

Want to know what test he had?

🧵👇

/1

[Coronary 4Front @Coronary4front]

Tense discussions about the 2023 @American_Heart @ACCinTouch chronic coronary guideline at the ACC board of trustees meeting this weekend in Vancouver. Expecting a joint statement soon addressing the controversy and ensuring fallout

[Nathan 🐸 Frogge MD @nfrogge]

@CMcNeelyMD Would take them off the table and discuss unless high-risk features (ongoing CP, unstable, etc) prompting ad hoc PCI. Looks like a relatively low SYNTAX score, so either would be reasonable.

[Sarah Hudson @sarahhudsonuk]

Ten current papers for the curious general cardiologist, covering topics including a potential future HTN Rx, new ACC/AHA guidelines for chronic CAD, red meat in CHD & real world TriClip outcomes

Sources: @Heart_BMJ,@CircAHA,@ESC_Journals,@JACCJournals,@JAMACardio,@NEJM

1/n

[Jamie McCabe @jamiemccabeMD]

Cats out of the Twitter bag so welcome to DELAWARE (DEliberate Leaflet Augmentation When Anchoring Requires Extra support). The idea is to ⬆️ friction in Ca+ free zones before TMVR in the context of non-circumfrential MAC by piercing & deploying AVP4 across leaflet. more to come

[Nathan 🐸 Frogge MD @nfrogge]

@BaoGTran Not routinely doing 1.25 upfront, but very reasonable in the “wire across and gear won’t go” scenario. I like your stepwise approach here. Thanks for sharing.

[Dr. Glaucomflecken @DGlaucomflecken]

Emergency medicine consults

[Nathan 🐸 Frogge MD @nfrogge]

@Tesslagra Wow. What did you use to get there?

[Rich_cathRT(CI)☢️ @Tesslagra]

Peekaboo technique fluoroscopically. Pt hand fully pronated with hub comfortably peeking out so operator can manipulate catheters ergonomically. 5 cm left out with hub just past midline of pt.

[Nathan 🐸 Frogge MD @nfrogge]

@TWilsonMD @perc_surgeon

[Ganesh Thirunavukkarasu, MD @djkesh2008_t]

Hi #CardioTwitter, what would this vessel with the stent, be called?
Large septal or small caliber distal LAD with large diagonals wrapping the apex?
@NYSCACC @DrBillLombardi @crfheart @thinkmdkane @CCCSymposium_NY @CRT_meeting @GiorgioMedranda @JDawnAbbott1

[Nathan 🐸 Frogge MD @nfrogge]

Asymptomatic 40-50 y/o with new LAFB. CV risk factors include HTN, HLD, OSA, and DM2 — all controlled on recent labs. What would you do? @DavidLBrownMD @CMcNeelyMD @SVRaoMD @prathakker @djc795 @ShariqShamimMD @mmamas1973 @CMichaelGibson @MarcSintek

[Nathan 🐸 Frogge MD @nfrogge]

@Tesslagra What did you use here?

[Medlife Crisis (DEFUNCT) @MedCrisis]

Nephrologist, cardiologist and emergency physician sitting by the airport security gates watching everyone neck their entire water bottles

[Tomas Pueyo @tomaspueyo]

What's the biggest Mississippi city?
Chicago!

Why? Because of an ice age water stream

If you understand this, you can understand why Chicago is so huge today

And more importantly, why some cities thrive while others don't:

[Nathan 🐸 Frogge MD @nfrogge]

@AshleyGWinter Volume of MV repair (not just replacement). MV repair is an intricate & technique-dependent operations. Mortality data may be publicly available depending on state, but should ask. Good surgeons usually happy to disclose. If not forthcoming, red flag. @PujaKachroo