@TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @sulimov_dmitry @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini Exactly Intubated due to intolerable pain IA dissection Conservative management

@UddinAkhlaque @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @sulimov_dmitry @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini Severe central chest pain IA dissection TOE and angio show dissection CT confirmed Intubated

@TonyMain6 @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @sulimov_dmitry @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini Yes, IA dissection Yes,CT No issue with arch

@Almanfi_Cardio @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @sulimov_dmitry @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @DrTGupta @Ryvetsprog @Albouaini That’s right

@yourheartdoc1 @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @sulimov_dmitry @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini You are absolutely right Well done

@sulimov_dmitry @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini Indeed

@sulimov_dmitry @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini What was the mechanism ?

@sulimov_dmitry @TribelessSapien @adelhosieny @aspergian1 @agtruesdell @DrIHHashmi1 @argulian @DrDamluji @evandrofilhobr @djc795 @Dr_Bitar @Babar_Basir @SripalBangalore @DBelardoMD @Almanfi_Cardio @DrTGupta @Ryvetsprog @Albouaini Very close

No issue with access TF Not much calcium No PVL No gradient No issue with depth No pericardial effusion

No PVL No Gradient No issue with depth Not much calcium No issue with sizing

CT yes- what’s the mechanism

@dautov_MD This is like our Afghanistan- kabuli plov

@AndreasRck2 Excellent result We used multi-snare from left radial. For that remove LV wire and cross from Snare loop first

@DrIHHashmi1 Possible loading issue . fluoro load checks will be helpful to see

@DrRajeshVijay @mmamas1973 @aayshacader @Hragy @mirvatalasnag @PCRonline @SCAI @escardio Here is clarity of this case in my view. This patient suffer from swollen difficulty or hiccups. You bring patient to Cathlab ask him to swallow barium and same time you do aortogram to assess aberrant (ARSA) /arterial lusoria to see how esophaguous compress to make diagnosis.

@mandeep_mayo Not proper crack calcium IVL will do great job here

@mandeep_mayo IVL will do the job

@DrDerekConnolly @SWBHnhs @AstonMedicine @AstonUniversity @CardiologySWBH @PCCS_UK Many congratulations !!!! This is thoroughly deserved