RT @PCRonline: TAVI and FFR-guided PCI vs. SAVR and CABG in aortic stenosis with complex or multivessel coronary artery disease 🔗 https://t…

@SripalBangalore @jl35wilsonMD @BSCCardiology I have a similar radial setup with the controls and run into this exact problem. @BSCCardiology needs to do better

@Hragy I would balloon the om and stent only if sizable. Treat the rest medically. No good target in the LAD. RCA non obstructive.

@UKheartresearch @GreggWStone @ziadalinyc @mbmcentegart @DFCapodanno @DrPeterOKane @JACCJournals @PCRonline @mmamas1973 @REVIVED_BCIS2 @alaide_chief I would tell the pt about the study. Then proceed to fix it if the pt agrees. Studies have limitations. With such good target in the LAD I'd take my chance. Both as a pt and as a provider.

@jl35wilsonMD @CMcNeelyMD @djc795 @ShariqShamimMD @cardioPCImom @DavidLBrownMD @timir_paul @kerrigjl @Umair2017 @JmKsnow @KPujdak @SVRaoMD @MusaSharkawiMD I wouldn't do anything else. You have good apposition and a good MSA. Most of this is positive remodelling.

@jl35wilsonMD @TWilsonMD @LAzzaliniMD @Umair2017 @kerrigjl @Allison_Dupont @nyalborgesmd @agtruesdell @CMcNeelyMD @GabashaMD @mirvatalasnag @KPujdak No good solution. Stent won't stay open in esrd with poor outflow. GDMT to prevent cardiac events. If refractory angina maybe coronary sinus reducer if future trials are promising.

@jl35wilsonMD @TWilsonMD @Umair2017 @mmamas1973 @adityadoc1 @AntoniousAttall @Allison_Dupont @nyalborgesmd @CMcNeelyMD @ShariqShamimMD @jedicath @DrJayMohan @kerrigjl Good result. Somehow I have started to admire the concept of TAP more than any other technique. Less metal simple steps. Only caveat is risking the sidebranch with the first stent

@DrSiyabMD @jl35wilsonMD @TWilsonMD @Umair2017 @mmamas1973 @adityadoc1 @AntoniousAttall @Allison_Dupont @nyalborgesmd @CMcNeelyMD @ShariqShamimMD @jedicath @DrJayMohan @kerrigjl Balloon anchor works well for that

@TWilsonMD @ShariqShamimMD @jl35wilsonMD @kerrigjl @nyalborgesmd @mornei2011 @evandrofilhobr @DrIHHashmi1 I would try once antegrade with tappered hydrophilic wire. Would not spend too much time on it though.

@TWilsonMD @kerrigjl @SyedYNaqvi1 @mornei2011 @jl35wilsonMD @jedicath @evandrofilhobr @DrIHHashmi1 @nyalborgesmd @CMcNeelyMD @mmamas1973 Effient 5 similar efficacy as plavix with consistent response and less bleeding. Good option for <100 kg

@TWilsonMD @jedicath @ShariqShamimMD @HadyLichaaMD @jl35wilsonMD @DrAmirKaki @DrIHHashmi1 @DanielJohnsrud @agtruesdell @KateKearney4 @luciotpadilla @evandrofilhobr @kerrigjl Great result 👏. Not a bad idea to leave rca alone if no symptoms.

@TWilsonMD @ShariqShamimMD @HadyLichaaMD @jl35wilsonMD @DrAmirKaki @DrIHHashmi1 @DanielJohnsrud @jedicath @agtruesdell @KateKearney4 @luciotpadilla @evandrofilhobr @kerrigjl My pt would be on OR schedule in a month

@jl35wilsonMD @DavidLBrownMD That's going in my dot phrase

@DanielJohnsrud Her QT improved in a few days. EF didn't change much. Will share the 1 month echo.

@drmomani Looks like you intended to deploy slightly more aortic. I could see that you might have even pulled in the middle of deployment. It foreshortened quite a bit from the top. Did you expect that? Great case.

@DanielJohnsrud Severe COPD was the only risk factor. No inciting event. Agree apex appears to be moving slightly better than the mid ventricle. Hope its tako and recovers in a few days.

@jl35wilsonMD Barely injecting into the LAD caused the VT. Didn't want to distrupt things in there especially with TIMI 3 flow. Other angles looked ok. That 950 psi hand injection not good enough?

@TWilsonMD Agree. I'm scratching my head on this one. @mahali87 @Firaszahwe #EPeeps

@jl35wilsonMD @TWilsonMD @DanielJohnsrud @ShariqShamimMD @mmamas1973 @mandeep_mayo @ACSCardiology @Obisht @Drdevignair @AllaqabanSuhail @SYandrapalli