Ahmed Almomani
@drmomani
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993
Interventional Cardiologist, Director of Structural Heart Disease Program @UTHealthSA and @UnivHealthSA | Associate Prof. of Med @TheLongSOM | @UTHealthSAValve
San Antonio, TX
Joined January 2011
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My amazing wife knows exactly what I like to do! She baked and made this 🎂 herself at home for my birthday! 😍😎
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Wondering what is causing the ST elevation/changes 🤔? By the what left system is normal.
@FawadVirk1
17
27
110
Patient: Doc, I felt good for one year after my mitral valve replacement (at OSH), then I started to feel bad again. Me: I wonder why 🤔
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Congratulations to our 👨🎓 👩🎓 Cards and IC fellows
@UTHealthSA
! We are proud of you! Thank you for this kind recognition! I have learned so much form every single one of you as well!
@FawadVirk1
Dr Roy, Dr Cheema, Dr Hughston
@elias_ghazwan
Dr Harfouch, Dr Parmar, Dr Rodriguez 👍
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Another example of our
#SHD
awesome team work delivering cutting-edge therapies to our patients in San Antonio & South Texas
@UTHealthSAValve
@UnivHealthSA
@UTHealthSA
@SouthTexasMed
antegrade
#LAMPOON
& transcatheter Mitral Valve Replacement
#TMVR
in MAC with excellent result!
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6
50
#HOCM
gradient 80 mm Hg despite medical therapy. Septal branch goes all the way to inferior part of the septum. Concerns about alcohol leaking to the inferior wall if injected during septal ablation.
@UTHealthSAValve
@MdFeldman
@UditBBhatnagar
@UnivHealthSys
@UTHealthSA
4
15
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How do you deal with heavily calcified bioprosthetic valve leaflet during BASILICA? Trifecta VTC 2.5 mm
@CathElectroSurg
@AdamGreenbaumMD
@jtsaxon
@akcmahi
@MohammedQintar
@BillONeillMD
@kalazizimd
@SachinGoelMD
Took multiple attempts 2 or 3 Astato wires to traverse the leaflet
10
9
43
Getting this balloon across the septum next to this ASO device was simply painful!!! 😬
6
4
46
The 3 pigtail trick always comes in handy to minimize contrast in CKD patient during
#TAVR
@UTHealthSAValve
@AnandPrasadMD
@UditBBhatnagar
@DawnHuiMD
5
8
44
Thankful for our great team who made this possible
@AnandPrasadMD
@DawnHuiMD
@hinan_ahmed
@CountryPumpDoc
, the amazing staff
@UnivHealthSA
&
@UTHealthSAValve
and our friend Dr Eng.
#TAVR
#SanAntonio
Today, our physician Dr. Ahmed A. Almomani became the first in San Antonio to perform an innovative new version of the TAVR procedure.
The transcaval TAVR expands access of this type of treatment to patients who would not traditionally be candidates.
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Thankful for a great & productive year (2019). Finished my
#SHD
training with leaders in the field
@MidAmericaHeart
to join another robust
#SHD
team
@UTHealthSAValve
#TAVR
#MitraClip
#TMVR
#VinV
#BVF
#MelodyValve
#ASD
#PFO
#HOCM
and more
@UTHealthSA
@UnivHealthSys
@SouthTexasMed
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6
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Native aortic valve balloon-assisted
#Basilica
for low LM height, effaced sinuses & high risk of coronary obstruction with
#TAVR
. Another first in south Texas by
@UTHealthSAValve
amazing team bringing innovations to the region.
@mhammadah
@DawnHuiMD
@AnandPrasadMD
@SAIFSanAntonio
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8
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@SAIFSanAntonio
it is over due but please join me to welcoming Dr. Hammadah
@mhammadah
, Interventional cardiology & Structural Heart Disease to the Division of Cardiology
@UTHealthSA
@UnivHealthSA
. Dr Hammadah finished his CV and IC fellowships
@EmoryUniversity
& SHD
@MHIF_Heart
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2
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Amazing
#SHD
fellowship year
@MidAmericaHeart
! Great graduation dinner and T-shirt gift from
@akcmahi
to help with transition into my new job in Texas :) Thankful for everyone
@MidAmericaHeart
@akcmahi
@jtsaxon
Dr Baron, Dr Hart
@khuberf1
@djc795
@davidskolnick01
@michaelleemain
11
6
38
It was great to kick off the
#SHD
program in the new HVI cath labs
@UnivHealthSA
with a successful
#watchmanFLEX
day and this wonderful team!
@UTHealthSA
@UTHealthSAValve
0
1
37
What are your plans and techniques to deal with the worldwide iodinated contrast shortage
#contrastshortage
? If you have not discussed it yet at your program, be ready to discuss it! Let us learn from each other!
#CardioTwitter
please share your ideas!
#PCI
#TAVR
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#COVID19
#stayhome
but do not ignore your heart attack..
#cardiotwitter
#SanAntonio
@UTHealthSA
��
@UnivHealthSys
@SCAI
@SAIFSanAntonio
@SAMetroHealth
@Cardiology
3
9
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This week we did the sign off for our 5 new cardiac/EP labs including a state of the art second hybrid room for our
#TAVR
and
#SHD
cases. Looking forward to treating our patients in this new and amazing HVI starting January
@UnivHealthSys
@UTHealthSA
@UTHealthSAValve
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2
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19 Mitroflow (ture ID 15.5) with severe AS mild to moderate AI, very narrow sinuses and very low LM suppling proximal LAD/Diag and OM 1, atretic LIMA to distal LAD, RCA ostial CTO with patent graft. Not a surgical candidate.
@UTHealthSAValve
3
4
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Incomplete plamar arch with digit ischemia due to radial occlusion, treated with endovascular repair
#RadialFirst
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10
32
PDA in adults is rare & interesting! Definitely, closure procedure is neat & gratifying! 45 yo patient with dyspnea and machinery murmur of PDA (Confirmed by echo & CT). Qp/Qs 1.7, PASP 37 mm Hg decreased to 23 mm Hg after closure!
@UTHealthSAValve
@UnivHealthSA
@SAIFSanAntonio
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3
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35+ year-old technology that still does the job well.
#InoueBalloon
#SHD
@UTHealthSAValve
@UTHealthSA
@FawadVirk1
@AkhtarA78346130
3
6
30
Exciting first 2 days for our new IC fellow
@elias_ghazwan
@UTHealthSA
#TAVR
#BAV
#Rotablation
x2
#coronaryIVL
X2
#impella
#Laseratherectomy
& other Cors & PAD work only in 2 days! Way to start!! Major credit to cathlab director
@AnandPrasadMD
&
@MarleneGMD
@SAIFSanAntonio
3
6
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Kinked guide due to severe tortuosity preventing stent delivery. Successfully managed with "Guidoplasty" high pressure balloon inflation at kink site (arrow) and Guideliner to provide more support/stiffness to the guide body. Stent delivered successfully!
#RadialFirst
3
8
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Low Wilkins score (5) rheumatic mitral stenosis, when PTMC works like magic
@mhammadah
@UTHealthSAValve
2
5
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BA-BASILICAL, BVF 18 mm balloon with LM protection after 23 mm Evolut, and final results mg 10 🙏. One of 2 basilica cases this month at
@UTHealthSAValve
@UnivHealthSA
with
@mhammadah
@AnandPrasadMD
complex
#TAVR
@TAVRBot
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4
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Going from P4 to P8 on
#Impella
5.5.. impressive wavefore.. let the impella do the work and the LV take a nap and rest, hopefully it will get its strength back soon.
@UTHealthSA
@UnivHealthSys
@CountryPumpDoc
@AJCrpntr
@KatieSDodd
@BillyStaffordRN
1
9
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Can you tell what brand are these LCx stents? Implanted in 1998.
@djc795
@WilliamWuHVC
@ahakeem143
@jtsaxon
@AnandPrasadMD
#RadialFirst
11
5
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Internal jugular access for pulmonic valve-in-valve implantation, something I learned today.. thank you
@tomsummitt1
and Dr Zamora
1
4
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We did our first distal left radial access to peripheral case today with 120 cm destination sheath, fixed an iliac
#CTO
. It was great!
#R2P
#Radialfirst
#dltra
@ArHeartHospital
Dr Rollefson
2
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LAD and RCA
#CTO
same patient same day.. before, I thought I am not getting into
#CTO
space 🤷🏻♂️ (I know the LAD looks easy)
#CHIP
@SAIFSanAntonio
@UTHealthSA
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@EleidMack
This is an extracardiac mitral valve conduit/replacement, between the LAA and the LV Apex with an epic valve in it to treat severe MS. Your wire going RA transseptal to LA then to the LV through the conduit, back to through the native mitral to the LA and externalized.
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Triple
#CTO
(LAD, OM and rPL) & LM/LAD/LCx DK crush & PDA PCI… complete revascularization in one session.. patient not surgical candidate.
@UTHealthSA
@UnivHealthSA
@SAIFSanAntonio
@elias_ghazwan
#CHIP
#highriskPCI
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3
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45 yo patient with severe rheumatic mitral stenosis, did an angiogram before an intended valvuloplasty, and here is my surprise!! Interestingly never had chest pain, but always felt tired and was not able to participate in sports growing up. Note PA catheter.
#SHD
#RadialFirst
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@sarahhudsonuk
Great case Sarah! I am glade you used OCT. As we all know FFR is not reliable in ACS culprit lesions and we must image if negative. We use the algorithm attached also see link:
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The elongated LVOT allowed for intentional subannular landing zone/deployment 29S3 + 2 cc with is 25% oversized. Resulted is a very nice waist and seal. Echo images to follow. Patient has a pre-existing RBBB and first degree with some drops beats, so PPM was placed before TAVR
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Follow up on this case. Discussed options with the patient, elected for device closure. Successful closure with an ASD occluder for the anterior defect and cribriform septal occluder for the posterior defect. Thanks to
@jtsaxon
for sharing his experience with a very similar case.
How to treat this septal defect? 55yo male large RV, Qp/Qs 2.4, BMI 50
@jtsaxon
@akcmahi
@JasonFoerst
@PSorajja
@AdamGreenbaumMD
@lamelaspablo
@ahakeem143
@SachinGoelMD
@AshishPershad
@adnanalkhouli
@GuiAttizzaniMD
@ekgpdx
@caresans26
@aelsab
@apurvabadheka
@TheNarulaSeries
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#shockwave
is definitely a game changer. 65 yo post laryngectomy, NSTEMI, CS, LM thrombus and 3 vessel disease, ostial 99% RCA, severe iliac disease. Shockwave of the iliac,
#impella
CP, single access, complete revasc. patient d/c home in few days.
@SAIFSanAntonio
#CHIP
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Dr Huber
@khuberf1
speaking about Managment of LAA closure complications at
#ISLAA2019
@MidAmericaHeart
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What is the highest aortic mean gradient you treated with
#TAVR
?
@AnandPrasadMD
@DawnHuiMD
@ricky_cigarroa
@little_tx
and I had our record case today! 127 mm Hg by echo and 122 mm Hg invasive 😳
4
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Today I did a
#TAVR
with bivalirudin, patient has Hx of HIT, and had to use a combination of proglides, angioseal and >25 minutes manual pressure to achieve hemostasis. I like to learn from your experience with TAVR and HIT, do you use bivalirudin? How do you manage access?
9
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Did not expect to see this in San Antonio Tx! 🥶... Happy Valentines Day!!
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ACC/AHA 2020 valve guidelines: Low and intermediate risk patients Age >80 with suitable anatomy TAVR is class I while SAVR is class 2a, Age 65-80 both TAVR and SAVR are class I. Shared decision-making by the heart team and the patient is the key!
@UTHealthSAValve
@AnandPrasadMD
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Best patient care, and great work environment.. you guys are awesome!!! Best cath lab in Texas!!!
Proud of our cardiac catheterization lab nurses, technologists, receptionists and supportive staff for the great work they do. Congratulations for the numerous awards you earn each year, and 2020 was not an exception!!
@UnivHealthSys
@UTHealthSA
@Cardiology
@ACCmediacenter
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San Antonio continues to bring interesting pathology, second PDA closure is few months. Both patients in there 40’s. Thankful to be able to serve the community and make an impact in patient care with our awesome team
@UTHealthSA
@UTHealthSAValve
@UnivHealthSA
@SAIFSanAntonio
PDA in adults is rare & interesting! Definitely, closure procedure is neat & gratifying! 45 yo patient with dyspnea and machinery murmur of PDA (Confirmed by echo & CT). Qp/Qs 1.7, PASP 37 mm Hg decreased to 23 mm Hg after closure!
@UTHealthSAValve
@UnivHealthSA
@SAIFSanAntonio
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3
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0
2
15
As many of you correctly concluded, this is a patient with previous ROSS and severe AI, the annulus of the autograft is very large and will not allow for 20% oversized of an S3RU valve, however, patient has an elongated LVOT which is not very contractile
3
2
15
When you ask for an AVP during a
#PVL
closure and your staff ready to be done after a long
#SHD
day and give you an MVP 🤣
#bestcathlabstaff
@UnivHealthSA
@UTHealthSAValve
#bestnurses
#bestCVtechnologists
I love you guys & love the pics I somehow find on my 📱 after the cases!
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Severe AS in a low risk patient (STS PROM 2.5%), annulus 435/75, SOV 28/28/29, mostly effaced STJ with low LM at 8 mm. Pictures below. What would you do? Please comment if other..
#TAVR
#SAVR
@UTHealthSAValve
23 or 26 S3, protect LM
32
23 S3 do not protect LM
13
29 CV, check LM at 80%
8
SAVR
94
13
4
14
@adnanalkhouli
@djc795
@SachinGoelMD
@JACCJournals
@GilbertTangMD
@igeorge1975
@willsuh76
@Almanfi_Cardio
@akcmahi
@MSampleMD
@AnkurKalraMD
@AGoldsweig
@maor_elad
It depends on who was included in the data. Most BEV programs use SEV in severely calcified annuli, very small annuli and ViV cases. Some of these cases are higher risk for PVL, PPM and other complications, thus we get such results. Registry data.. who knows🤷🏻♂️
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@JoChikweMD
@tssmn
@CedarsSinai
So are we comparing operable vs inoperable patients? TEER is only done in very high risk/inoperable patients for primary MR! So not sure if we are comparing apples to oranges here (selection bias)! This is an honest question and I will appreciate it if you help us understand!
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1
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@SAIFSanAntonio
Please join me in welcoming Dr. Imran Aslam, Interventional cardiology & Advanced Heart Failure to the Division of Cardiology
@UTHealthSA
@UnivHealthSA
Dr Aslam went to
@TheLongSOM
then completed IM residency, Cards, IC and Advanced HF training
@HopkinsMedicine
0
4
13
Excellent training, high volume and great mentors! One of the best
#SHD
fellowship programs!
The Structural Cardiology Fellowship at
@saintlukeskc
@MidAmericaHeart
is accepting applications for AY 2021-2022! Train with experts in the field of interventional cardiology and participate in a high volume of cutting edge procedures!
DM for details
@akcmahi
@jtsaxon
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0
2
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@jtsaxon
@rational_doc
@ekgpdx
@willsuh76
@PinakShahMD
@duanepinto
@JasonFoerst
@ajaykirtane
@SVRaoMD
@CardiacConsult
@HeartOTXHeartMD
@khuberf1
@djc795
@akcmahi
I totally agree with
@jtsaxon
!! I am currently a structural fellow
@MidAmericaHeart
and my experience has been amazing!! I definitely encourage all IC fellows who have passion for structural heart interventions to do a dedicated year of training! (1/2)
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Patient with severe AS, NYHAII symptoms. Intermediate to high risk, Pre
#TAVR
PCI done for a proximal to Mid significant LAD lesion. After PCI patient feels much better and reports complete resolution of symptoms! What would you do? I know it is not uncommon!
Exercise stress test
60
Proceed with TAVR
90
Follow up in 3 months
50
Other, please comment
5
12
4
12
@bcostelloMD
@majazayeri
@APostalian
@KBalakumaranMD
@SamRRazaMD
@lamelaspablo
@MedCrisis
@mirvatalasnag
@DrLaxmiMehta
@dr_chirumamilla
@Pooh_Velagapudi
@purviparwani
@gina_lundberg
@DrMarthaGulati
@iamritu
@DocSavageTJU
@NirmanBhatia
@RezaEmaminia
There is clear constant hanging in the LAD.. I vote for IVUS then PCI.. FFR/iFR is only useful if positive in this UA patient. If negative, you have to confirm with an imaging study.. FFR is for SIHD, and cannot r/o an unstable plaque
1
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Before you ask, patient has multiple previous sternotomies and not a candidate fore surgery per 2 of our very experienced congenital heart surgeons.
1
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@UTHealthSAValve
awesome team continues to bring new treatments to South Texas. Mitral bioprosthetic valve degeneration, not a surgical candidate, risk of LVOT obstruction. Tip-to-base
#LAMPOON
, valve-in-valve
#TMVR
with
#BVF
@AnandPrasadMD
@DawnHuiMD
@SAIFSanAntonio
#SHD
1
4
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@lamelaspablo
@FawadVirk1
This was only time I was able to write “esophageal perforation” in a coronary angiogram report! 😅
1
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What is wrong with this angiogram? Patient with anterior ischemia, what would you do next?
#RadialFirst
18
5
11
@AnandPrasadMD
@UnivHealthSA
@UTHealthSA
@SAIFSanAntonio
@cardio_renal
@UTHealthSAValve
@MarleneGMD
It is a great facility, excited to do the first Watchman Flex Monday and first TAVR Thursday in the new hybrid suite, which has all the bells and whistles! Next week will be awesome!
0
1
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PVL defect was 1.2 x 1.1 cm. Was able to advanced the agilis thought it and closed with Muscular VSD occluder.
2
0
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Thanks for
@tomsummitt1
for his support.. proud of my team and colleagues
@DawnHuiMD
@AnandPrasadMD
@hinan_ahmed
@CountryPumpDoc
@UTHealthSA
@UnivHealthSys
and thankful for my mentors at
@MidAmericaHeart
@akcmahi
@jtsaxon
@djc795
5
0
10
How do you deal with Asymptomatic Bacteriuria prior to TAVR?
@jtsaxon
@Almanfi_Cardio
@PaulMahoneyMD
@PSorajja
@KHERA_MD
@J_M_McCabe
@akcmahi
@djc795
@GilbertTangMD
@adnanalkhouli
@AdamGreenbaumMD
@kalazizimd
@sameergafoor
@tavrkapadia
@JasonFoerst
@tnazifMD
@willsuh76
@HarshGMD
Delay TAVR, Do Cx & Abx
31
empiric abx, procd w TAVR
37
Usual pre-op like anyTAVR
32
Why do UA if asymptotic
47
7
4
10
How to treat this septal defect? 55yo male large RV, Qp/Qs 2.4, BMI 50
@jtsaxon
@akcmahi
@JasonFoerst
@PSorajja
@AdamGreenbaumMD
@lamelaspablo
@ahakeem143
@SachinGoelMD
@AshishPershad
@adnanalkhouli
@GuiAttizzaniMD
@ekgpdx
@caresans26
@aelsab
@apurvabadheka
@TheNarulaSeries
Refer to surgery
45
Try 2 Amplatzer devices
37
Try 2 Cardioform devices
11
Other! Please comment
6
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2
9
Amazing Inauguration cases in the first few months
#TAVR
#TAVRinTAVR
#TMVR
#PVLclosure
#Angiovag
#CTO
#CHIP
and much more. Glad he joined us to severe our population is San Antonio and South Texas
@SouthTexasMed
@UTHealthcareSA
@UnivHealthSA
@UTHealthSAValve
0
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This is simply amazing!! Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients | NEJM
0
1
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2
5
9
We had the pleasure to have Dr Mauro Carlino visiting us at
@Uamscardiology
and
@ArHeartHospital
amazing
#CTO101
teaching cases and techniques.
1
0
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Excellent Structural Heart Disease sessions at Texas
#CardiologyPulse
2019
@UTHealthSA
@hinan_ahmed
@Stevenrbailey1
@RizikMd
@DawnHuiMD
@n_kleiman
@houmavalvedoc
@HenrytTimothy
0
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VCT was measured with intention for 23 valve in 21 Mosiac + BVF
1
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I will start! We are discussing canceling elective cases. Using something like DyeVert Plus injection systems that can recycle wasted contrast. CO2 contrast for peripheral. Ultra low contrast PCI and TAVR.
1
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Proud of you
@badrharfouch
Join us at 7:30 AM ET Wednesday for cath conference.
@badrharfouch
will discuss "Coronary Artery Perforation: A Rare Serious Complication of Pericardiocentesis."
If you need a registration link, please email mwhc.cathconference
@gmail
.com
1
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Post TMVR final results, no PVL! 💪
@AnandPrasadMD
@DawnHuiMD
@AJCrpntr
@hinan_ahmed
@ricky_cigarroa
@CountryPumpDoc
@tomsummitt1
2
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@jtsaxon
@jaygirimd
@michaelleemain
@saintlukeskc
@akcmahi
Thank you for a great first official TAVR day for me as a structural fellow!!
@jtsaxon
Dr Baron
@michaelleemain
and Dr Allen
@saintlukeskc
0
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@UTHealthSA
the cardiology floor
@UnivHealthSys
, our post
#TAVR
patients get this kind of special treatment in addition to the new valve!!
@AnandPrasadMD
@DawnHuiMD
@hinan_ahmed
@AJCrpntr
#SanAntonio
1
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Iliac and SFA interventions through left
#RadialFirst
using the new 119 cm
#R2P
Destination Slender sheath.
1
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@badinmd
speaking about “Afib, whom to consider for ablation” at
#HeartRhythmFocus
San Antonio Symposium by
@UTHealthSA
cardiology.
@UTHealthCME
@UnivHealthSys
@CountryPumpDoc
@JayasreePillar3
0
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