Adnan Chhatriwalla
@akcmahi
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Interventional Cardiologist, Structural Interventionalist, Outcomes Researcher at Saint Luke’s Mid America Heart Institute
Kansas City, MO
Joined July 2015
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RT @sellers_steph: New from the CV Translational Lab & Explant Valve Registry: redo-TAVI with the SAPIEN 3 in degenerated calcified CoreVal…
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RT @MidAmericaHeart: Happy to share that the @MidAmericaHeart team was the first in the region to perform transcatheter tricuspid valve rep…
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RT @GilbertTangMD: How to quickly engage coronaries after #Evolut FX+ #TAVR? Align the 2 dot markers in LAO view like the 1:2 view of SAVR…
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@gb_mackensen @SachinGoelMD @jamiemccabeMD @psorajja @kashishgoelmd @PradeepYadavMD @GilbertTangMD @mirvatalasnag @EleidMack @tavrkapadia @bapat_savrtavr @NadeenFaza @SLittleMD @sameergafoor @drrahulpsharma @PaulMahoneyMD @AdamGreenbaumMD @SCAI @ACCinTouch @CathElectroSurg 100% agree with this. Nomenclature is the issue, there is no paravalvular leak here, the ring dehisced and there is central MR. Not that MTEER will be be easy but it’s the best first option.
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@PinakShahMD @willsuh76 @GilbertTangMD @mw_sherwood @mirvatalasnag BVF/BVR would do little in this situation, the maximum balloon size to use in a 26 Evolut is 24 mm so the gain would be minimal. I think this has more to do with the autoimmune condition than the underexpansion of the THV
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@mmamas1973 @djc795 Is this serious? Someone as smart as David Cohen is with numbers wrote 9 and not 10 commandments? 😂
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@fjsawaya @mirvatalasnag @AlkashkariWail @GhazzalZiyad @stepoco @RonnieRamadan @GilbertTangMD @modine_thomas @TAVRBot @didier_tchetche @AUBMC_Official I think it’s possible that BVF had something to do with the late PVL but I don’t know how probable it is mechanistically. We just closed a large PVL that occurred 30 years after mechanical MVR, why it occurred we don’t know. In any case a good reason to collect long term BVF data
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@PradeepYadavMD @djc795 @care4urheart2 @HarshGMD @ShariqShamimMD @abadkhan2002 @GilbertTangMD @_PraveenChandra @drrkhyd @mmamas1973 @DrRajeshG1 @evandrofilhobr @HadyLichaaMD We have a nice video of a fracture at 12 atm. But we haven’t tested just a hand inflation. Agree with you Pradeep, I don’t suspect that accomplishes much.
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@care4urheart2 @ShariqShamimMD @abadkhan2002 @GilbertTangMD @_PraveenChandra @drrkhyd @PradeepYadavMD @mmamas1973 @DrRajeshG1 @evandrofilhobr @HadyLichaaMD @djc795 @HarshGMD Or there is always this
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@care4urheart2 @ShariqShamimMD @abadkhan2002 @GilbertTangMD @_PraveenChandra @drrkhyd @PradeepYadavMD @mmamas1973 @DrRajeshG1 @evandrofilhobr @HadyLichaaMD @djc795 @HarshGMD We don’t have AVP3 in the US outside of the PARADIGM trial so our experience is limited. I understand you can “right size” the defect so maybe it could have worked or at least significantly reduced the PVL. We would use 2 or 3 AVP2’s, ADO2’s too expensive for us.
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@djc795 @HarshGMD @ShariqShamimMD @care4urheart2 @abadkhan2002 @GilbertTangMD @_PraveenChandra @drrkhyd @PradeepYadavMD @mmamas1973 @DrRajeshG1 @evandrofilhobr @HadyLichaaMD Agree. Stand alone BVR is not a solution to any problem. In this specific valve either it would recoil and nothing would change or it would remodel and you would have wide open AI.
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@ShariqShamimMD @care4urheart2 @abadkhan2002 @GilbertTangMD @_PraveenChandra @drrkhyd @PradeepYadavMD @mmamas1973 @DrRajeshG1 @evandrofilhobr @HadyLichaaMD @djc795 @HarshGMD This was an Inspiris valve that stretched/remodeled with VIV TAVR? Otherwise VIV TAVR without BVF/BVR would not fix a PVL. This is a nice case that could have been done either way - try PVL closure first or VIV TAVR first with the other as the backup option.
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@adnanalkhouli @ChetRihal @MayoClinicCV @MayoClinicCVS @JACCJournals @jaygirimd @TsuyoshiKaneko1 This is terrific and the solution is terrifying to many
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@jtsaxon @homam_heartdoc @AGoldsweig @JACCJournals @Baystate_Health @AmirLotfi9 @chetanhuded I would target the fossa
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