RIP is a great technique, but don't just read the article without following @swissCTO’s advice: check your toolbox beforehand to know what fits into the balloon shaft! 🛠️ My introducer needle didn't work out—a lesson I learned mid-complication. Luckily, the perforation was into the LV. Lots of points to discuss but I just wanted to share the complication and share the setup that actually works in my cath lab ( at the end of the video ). Check it out 👇 #CardioTwitter #PCI #CHIP

What an amazing ballon, so many off label indications. PPBV. Pre procedure PPG 140mmHg. Post procedure PPG 26 mmHg.

#Sharing for learning ANGIOGRAPHIC CASE SPOTTER An angiogram that I have never seen before—and I suspect most of us haven’t either! What is your diagnosis? More importantly: What would be your management strategy?

Anyone doing this- prolonged balloon inflation during STEMI “primary PCI assigned 1:1 to POP (stent inflation to ≥14 atm maintained until pressure stability, defined as no pressure drop ≥0.3 atm over 30 seconds) or conventional rapid inflation–deflation stenting” #CardioX

Drive-by LIMA angio on a patient that needs CABG. Cardiac surgeon, do you find these helpful? Easy for me to do since I am default left snuff box #RadialFirst #ldTRA 👍

On my last day @#SCAI2019, there was an interesting debate between Cliff Kavinsky & @willsuh76 about if TAVR should continue being a 2-operator procedure or transition to a solo one. What say you? tctmd.com/news/tavr-operator… @drdevireddy @AnandPrasadMD @Rahul2282Sharma @sameergafoor

The Rise of the Solo TAVR Operator: Alone, Unarmed, and Unafraid sciencedirect.com/science/ar… Written before CMS finalized its new TAVR NCD - I think CMS got some of it right, and one big thing wrong. Braasch et al looked at 400K Medicare TAVRs, 2016 to 2024. Surgical bailout in 0.56%, falling from 0.92% to 0.40%. Hospital SAVR volume, whether low, intermediate, or high, was not associated with mortality among patients requiring salvage surgery. The absence of an on-site surgeon is not the absence of rescue. Transfer systems exist. A growing share of catastrophic complications, including contained annular injury, tamponade, and device embolization, are now rescued in the cath lab, far from the OR. We have run this experiment before - PCI required on-site surgery on the same theory. CPORT-E: over 18k patients, 6-week mortality 0.9% vs 0.8%. MASS COMM: emergency surgery in 0.1% to 0.3%. PCI without on-site surgery became standard. Systems of care exists across the spectrum of CV care: cardiogenic shock, PE care etc. What CMS got right in the final NCD: TAVR may be performed by a single operator. The mandated dual-specialty evaluation is dropped and only the operator's visit is required. Hospital procedural volume requirements are removed. Asymptomatic severe AS is now covered under CED. Where CMS got it wrong: on-site cardiac surgery is retained. It compels the backup that is so rarely needed. A system of care with straightforward TAVRs being performed by ICs in non-surgical sites with affiliations for complex/transfers would've balanced access. However, CMS & cardiac societies chose politics over patients in the end. Proof: no requirement for on-site EP, though permanent pacing is the most common service after TAVR. No requirement for vascular surgery - much more valuable to a TAVR operator than CV surgery. The mandate is kept to protect physicians not patients. Morevover, medicare imposes no minimum-volume condition on SAVR, despite a median annual surgeon volume of 16 cases. Volume, staffing and heart team requirements get framed as safeguards of quality. But they are absent for the surgical equivalent. Let's be honest - that framing is a pretext for protecting case volume, referral patterns, and established programs. Legitimate interests, just not the ones a public payer is charged with protecting. CMS exists to serve beneficiaries. Its mandate is to protect patients, not programs or professions. Where a requirement principally constrains competition, restricts access, or entrenches incumbents without corresponding patient benefit, it should be removed. Politics over patients. The solo TAVR operator is not a threat to patients. It is the means of reaching them. Hardly unarmed: percutaneous rescue, disciplined case selection, a defined transfer network. CMS came some of the way. They didn't have the courage to do the right thing and patients will pay the price. doi.org/10.1016/j.jcin.2026.… @JACCJournals @SCAI @ACCinTouch @TCTMD @CRFheart @STS_CTsurgery @MayoClinicCV @rajivxgulati @SVRaoMD @drroxmehran @AjayKirtaneMD @mmamas1973 @rwyeh @adnanalkhouli @mirvatalasnag @jaygirimd @tjsimard @PietroDiSantoMD @OmarARazek @mandeep_mayo @willsuh76 @EleidMack @ChetRihal @MayraGuerreroMD @AbdullahAlabcha @aelsab @evandrofilhobr @Mahmoud_Ismayl @lamelaspablo #TAVR #TAVI

Emergent cath was the correct answer. Culprit was 100% occluded proximal RCA. 12 lead EKG doesn’t meet STEMI criteria but findings are consistent with inferior OMI needing emergency cardiac cath.

Truth of life! In conversation with pts, I always leave a 5% margin for mistake. Why 5? Because the confidence interval is 95%... We are human... @jedicath thanks for sharing! I will also show identical case later...

Every interventional Cardiologist-calling him(her)self an expert-has a plan till they get punched in the face with CS due to an acute LM occlusion STEMI …..

It is what it is. Nothing is 100% in life

#IVUS guided #BioPCI Episode 45 (6) #cardiology #interventionalcardiology #complexPCI #kidneytransplantation #drugcoatedballoon #cuttingballoon #uzbekistan @esbrilakis @gbiondizoccai @sbrugaletta @jbspadoni @realarainmd @Laserrman @TWilsonMD @yassersadeknhi @PCRonline @LAzzaliniMD @IhabFathiSulima @DFCapodanno @aspergian1 @stefan_harb @DrIHHashmi1 @mirvatalasnag @jedicath @ziadalinyc @Obisht @mmamas1973 @Hragy @TCT_ME_ @BSCCardiology

Crossing the CTO. Retrograde dissection reentry. #interventionalradiology #chronictotalocclusion #peripheralarterydisease #uzbekistan @FadiSaab17 @realarainmd @KambisMashayek1 @Laserrman @mmamas1973 @yassersadeknhi @TWilsonMD @aspergian1 @PCRonline @jedicath @DrAmirKaki @LAzzaliniMD @IhabFathiSulima @gbiondizoccai @DFCapodanno @FaustoHerediaDr

RT @nadig_cardio: Middle aged 👨 F/U c/AWMI primary ptca to LAD couple of weeks back Now —> Anomalous RCA from the left coronary sinus + di…

IVUS-guided analysis of LM crossover PCI demonstrated that suboptimal stent expansion independently predicts adverse 5-year outcomes. Optimising MSA is critical for long-term success. 🔗eurointervention.pcronline.c…

Complication sessions Happened during PCI to LAD-ISR, stented 10 yr back. What is the problem here and how to manage. IVUS done to resolve the puzzle shown 👇🏾

Happy Friday, Imagers! Something’s not quite attached… 👀 2D gives you the clue. 3D tells the story. Why might this patient be breathless? 🤔😮‍💨 #CardiacImaging #EchoFirst #MitralValve

TAVR implanted 7 years ago, now w CHF, sev AS/AI. I've had repeated success finding plane btwn native valve cusps & TAVR skirt, working w elevator instrument in R hand and gentle traction grasping top of frame w L hand to "pop" valve out. @M_Pompeu_Sa_MD @tomcnguyen #TAVR

Day 2 at #TCTMiddleEast2026. Post-MI VSR still kills most patients it hits. @AlkashkariWail on percutaneous closure when anatomy allows: single defect, under 24 mm, good rims, clear of the valves. Proud to call him an MNGHA colleague. @mirvatalasnag @TCT_ME_ @crfheart @AdelTash @drptca @mmamas1973 @Hragy @AlrahimiJ @DrAlsaiediAB

This DurAVR case presentation explores precision valve positioning and commissural alignment during transcatheter aortic valve implantation, presented by Andrea Scotti during Can Transcatheter Technology Approach Native Valve Physiology? at TIO Global 2026. A key focus is achieving accurate valve orientation using cusp overlap views, fluoroscopic landmarks and controlled manipulation of the delivery system. Andrea demonstrates how radiopaque markers and anatomical reference points help guide commissural alignment, supporting optimal valve positioning before deployment. A practical example of how procedural precision and imaging guidance are central to advancing transcatheter valve technology towards more physiological outcomes. #TIOCongress #StructuralHeart #TAVI #AorticValve #InterventionalCardiology