Gennaro Giustino, MD
@g_giustinoMD
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🇮🇹 Structural Interventional Cardiologist @AtlanticHealth Impossible is Nothing
New York, USA
Joined January 2011
Great valve-in-MAC case performed at Gagnon Cardiovascular Institute @AtlanticHealth using a novel technique for mitral valve leaflet modification (transeptal BATMAN), alternative to LAMPOON. Severe mitral regurgitation with severe mitral annular calcifications (MAC) adequate for anchoring with S3 valve. CT showing prohibitive risk of LVOT obstruction despite septal ablation (predicted neo-LVOT <100) therefore the patients would have required leaflet laceration. Anterior mitral valve leaflet was traversed with an Astato wire - Finecross microcatheter and JR catheter into a steerable Versacross. Subsequently the leaflet was ballooned with a coronary balloon and then the Astato wire switched to 0.035 wire via quickcross. Then, leaflet laceration was performed with a 14 mm Armada balloon and an S3 26 mm was implanted. Final echo showing no gradient across the LVOT and trivial PVL. Invasive hemodynamics also demonstrated no gradient. Procedure performed under 2 hours. Patient remained stable during the procedure with no need for mechanical cardiocirculatory support. Thank you to the amazing Structural team at Morristown Medical Center!!!! and to @HenryFordHealth @PedroMDMSc for his help! @philgenereuxMD
@KippermanRobert
@LindaGillamMD
@KKoulogiannis
@leomarcoff
@Edwards_TAVR
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@djc795 It’s the third time I did this and twice was for degenerated stenotic CoreValves, arguably the hardest to cross. With more failed Evoluts coming, antegrade approach may become more common
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@DrTGupta @HarryDauerman @ronylahoudmd @UVMLarnerMed @uvmcards @SachinGoelMD @kashishgoelmd @GilbertTangMD @PedroMDMSc @djc795 What’s 😳 to me is that I actually have never done PBMV in any other way other than this way… @HenryFordHealth style… congrats for the paper Tanush!
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@DrTGupta @HarryDauerman @UVMLarnerMed @Medtronic @EdwardsLifesci @PedroMDMSc @kashishgoelmd Agree Tanush! Nice job
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@Almanfi_Cardio Not really, patient had no PVL post-implant. These appear around 1 year later in the septal-anterior and postero-lateral position.
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RT @PedroMDMSc: Alternative access might be needed for other valves than aortic . RIJ PMBV @g_giustinoMD @lamelaspablo @AdamGreenbaumMD @So…
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RT @PedroMDMSc: For CS and AS single access Impella can be done with 8 to 10Fr. Just tip insertion. During pacing hemodynamics don’t change…
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RT @NEJM: New in the January 16, 2025, issue of NEJM: TAVR for Asymptomatic Severe Aortic Stenosis (EARLY TAVR trial)
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RT @PedroMDMSc: EVOQUE cases at Ford this week. Right and left transfemoral and right and left IJ. One case TTVR in TEER @g_giustinoMD @SCA…
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RT @JACCJournals: #JACCIMG multidisciplinary position statement: 3D-ICE is becoming a valuable complement & potential alternative to #echof…
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