Elon Musk tried to kill me but @willsuh76 did Twitter CABG to achieve ROSC. New protocol. Mention me and use #TAVR and I will quote tweet you. Example 👇 I ❤️ #TAVR @TAVRBot

This was straight AP. Pig in NCC. Lucent line nice and clear. Perfect 90/10 implant. #TAVR

#TAVR For years now, I’ve stopped looking at the center marker to determine implant depth and instead focus on lucent line. But can you believe that center marker at the annular plane was and still is the official teaching for implant depth for SAPIEN3?! This is way too deep!

BIG NEWS: CMS final TAVR coverage decision, biggest change to TAVR coverage since 2012. Here’s my summary from the long 105-page statement: - Symptomatic severe aortic stenosis is now covered as standard care. No mandatory registry enrollment. - Asymptomatic severe aortic stenosis is newly covered, but only for patients enrolled in Medicare-approved studies. - The heart team stays. Every patient still needs input from both cardiac surgery and interventional cardiology (can be done through chart review), plus an in-person visit with one TAVR operator before the day of the procedure. - The two-operator requirement is gone. Now one qualified operator can do the case alone. - Two operators are still covered if the heart team decides they’re needed and that can be in any combination: surgeon + interventional cardiologist, two interventional cardiologists, or two surgeons. - Volume requirements now apply to the operator, not the hospital: at least 20 transcatheter valve cases a year (15 of them TAVR). - Hospitals still need on-site cardiac surgery program. @6ayyeboon @AlkashkariWail @mirvatalasnag @BinAbdulHak_A @amrmohsen213 @MarwanSaadMD @aelsab @MusaSharkawi @MohammedQintar @mhammadah @JDDCFratti @acamajmd @Almanfi_Cardio @scottiejj12

Coronary protection during @TAVRBot Over the years we’ve learned that coronary height isn’t the only determinant. Solutions include electrocautery or stenting These issues are of particular concern in women & small patients often Case courtesy of #ThreeMuskateers @drptca @MogneeA @mirvatalasnag @phillipfreeman @PhilippLurz @colum_owens @adityadoc1 @ShariqShamimMD @kiadeb87 @djc795 @realarainmd @HindAlosaimi_

RT @MCoylewright: Sponsored by @EdwardsLifesci | I've had this happen. You see a severe aortic stenosis patient and they're asymptomatic. N…

RT @willsuh76: Severe AS can progress rapidly & unpredictably from asymp. to advanced symptoms. Age/biomarkers/cardiac damage/LV health can…

RT @willsuh76: ~40% of asymp. severe AS patients progress to advanced symptoms (acute valve syndrome) & face higher risks of death, stroke,…

86M severe AS & Prior stroke BEV platform & procedure time < 30minutes If risk of stroke is high, what are your technical tips? (Let’s put the EPD discussion to rest for now) ❓should we avoid multiple inflations ❓does the THV platform make a difference @TAVRBot @tavrkapadia @djc795 @AliSahebHusain @almoghairi @HatimLawati @AlhijjiM @fjsawaya @SSamargandy @yaqoub_lina @kalazizimd @AnasNomanMD @drptca @AlkashkariWail @TCT_ME_

#TAVR poll Patient had SAVR 10 years ago. Echo now shows AVA 0.5 cm2, MG 35 mmHg, Vmax 3.9 m/s, SVI 21 ml/m2, moderate AR. Patient has no symptoms. What next?

RT @MCoylewright: When's the right time to talk with aortic stenosis (AS) patients about treatment options and goals? Patients are ready ea…

#TAVR poll I like seeing patients with moderate aortic stenosis to explain diagnosis, natural history and surveillance. Also to develop a relationship with patient When do you like to see patients with aortic stenosis?

#TAVR Bumper Technique This visual shows how this technique works. Without bumper, the leading edge of the THV stent can catch a lip of calcium. With bumper, the 🎈bulges over the leading edge and protects it from catching calcium. Also prevents scraping in aorta.

#TAVR Bumper Technique This is something I’ve been doing and it makes crossing the aortic valve easy without pre BAV. After final valve assembly in descending aorta, roll contrast into the nose cone to create the bumper. 1. Reduces scraping in aorta. 2. Crosses like butter!

Treat the valve AND the myocardium when facing severe AS+amyloidosis. Both AVR and tafamidis independently ↓ mortality Dual therapy=best outcomes w/ similar survival to lone AS+AVR. Dual pathology is common (~13%) warranting RCT. tinyurl.com/2zmpht8x Bravo @ThomasTreibel! 👏🏻

Are we officially changing US nomenclature from #TAVR ➡️ #TAVI

#TAVR poll Patient with TAVR 11 years ago, S3 26 mm, MG 41 mmHg. CT shows HALT, leaflets no calcification. What is your anticoagulant of choice?

Is transcarotid TAVR a suitable alternative to SAVR in unsuitable transfemoral access? Transcarotid versus surgical aortic valve replacement for severe AS @MAvvedimento @delportilloJH @sidmengi_dr @pedro_cepas #AHAJournals ahajrnls.org/4iCJPEU

#TAVR poll Where is the cardiac surgeon during TAVR?

What would it take for TVT registry to be opened? Both @Edwards_TAVR and @MDT_StructHeart would have to agree? @ACCinTouch @STS_CTsurgery

Death is an undeniable hard outcome. #TAVR trials suggest that outcomes between BEV and SEV are similar. But look at MAUDE database. Search 7/1/24 - 12/31/24, outcome death. Edwards SAPIEN = 22 records Medtronic Evolut = 228 records 10-fold higher with Evolut 😳 Why?