Saving lives 81mg at a time. Interventional Cardiologist by day & night. HF & cardiogenic shock passionate. #RadialFirst but also #SafeFemoral. PGY-Forever 🦾.
Houston, TX
Joined May 2011
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Isaac Tea retweeted
No trial better explains the importance of evidence than REVIVED BCIS. It boggles my mind that it was negative
@divaka_perera is correct, but try telling 99% of American cardiologists
We still cath new LV dys pts TO FIND LESIONS TO REVASC despite negative trials #ESC2025
@divaka_perera makes a strong case: routine #PCI should not be performed in asymptomatic pts with LV dysfunction (even with viability). It does NOT improve prognosis ‼️
Evidence should guide practice: The earth is not flat 🌎
#ESCCongress @escardio @drjohnm
Isaac Tea retweeted
Question for those who have adopted bival for STEMI: do you do two hours or four hours after PCI for the infusion? Do you try to wean the radial band while it is running or just wait until it is done? Trying to build an order set…
Isaac Tea retweeted
ICU (Central Venous/Arterial) Line Secrets - Part 2:
Following from where I stopped last week (that's why I keep same numbering) & without hoping to a provide tutorial about how to place lines, there are some additional points that I find worth mentioning
nitter.gq/IM_Crit_/status/184505…
Isaac Tea retweeted
Quick tips from @jason_wollmuth on Single Access dry closure! #CardioTwitter #MCS
Isaac Tea retweeted
Dr. Jason Wollmuth gives a step-by-step guide on his Sideclose Technique! #CardioTwitter #MCS
Isaac Tea retweeted
DCB have been available for 14 years in Europe and elsewhere outside USA. As US IC are excited for DCBs, note the results with POBA were not always perfect. We don't know the role of DCBs in setting of dissections and recoil.
Diffusel disease in LAD and didn't want a FMJ so treated with DCB, before & after DCB 1/3
@mmamas1973 @djc795 @DocSavageTJU @rwyeh @Babar_Basir @SripalBangalore @Umair2017
Isaac Tea retweeted
I use Echonav for helping trainees understand the interplay between echo and fluoro through live real time fusion of modalities. Features allow for more intuitive instruction and understanding. Also the imagery is outstanding. Here's one of our examples. #UABStructural
Isaac Tea retweeted
#echofirst shows how surgical TEE view for MV-PPL (peri prosthetic leaks) localization corresponds to interventionalist’s view on fluoroscopy #CardioTwitter
doi.org/10.1016/j.jcin.2010.…
Isaac Tea retweeted
Almost all scores/biomarkers approaches in the contemporary era over predict CV risk
Time to pivot for a more accurate decision aid
#CacTesting #SeeDiseaseTreatDisease
How do the SCORE and SCORE2 perform in East Asian population? 🤔
In this #JACCAsia study on 324,384 subjects, both scores overestimate #CVD risk with low performance.
📣 New models tailored to the East Asian population are needed! bit.ly/4atC7sR
Amazing work from the DanGer investigators!!! Finally, an RCT for AMI-CS for an MCS device with a psotive outcome for Impella. A new era. Validates our efforts in the trenches to save these patients on death's door. 🦾 @Abiomed @CardioNerds @HMHCardioFellow
Isaac Tea retweeted
The TAVI-MultiCLOSE study investigated a new vascular closure algorithm, MultiCLOSE, for arterial access closure after transfemoral TAVI. This stepwise approach involves initial preclosure with suture-based devices, followed by a final closure customized through angiographic control. The study found that the MultiCLOSE algorithm effectively achieved arterial haemostasis with very low rates of vascular complications and mortality. Demonstrating ease of use, safety, and durability, the MultiCLOSE method significantly reduces major vascular complications, marking a promising advancement in post-TAVI patient care. ow.ly/xxbB50QWUhi
Editorial by @ThomPilgrim ; Annette Maznyczka ow.ly/u1aW50QZM5V
Isaac Tea retweeted
ICU Nightshift Secrets:
This will sound a lot as as cookbook medicine but bear w me. The 2 drugs that I use more than anything else whenever I'm on a nightshift are: furosemide & dexmedetomidine. If u don't use any of them, u are probably missing something
Case from last night:
Keep your Thanksgiving Day dinner conversations civil!
If uncle Bob thinks that IVUS guided PCI does not improve on all-cause mortality, MACE & TVR in AMI or Complex PCI, calmly redirect the conversation to 1 vs 3 month DAPT or something non controversial.
Happy Thanksgiving!
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Image courtesy of Xia et. al - IVUS Image Segmentation Using Superpixel-Wise Fuzzy Clustering and Level Set Evolution
mdpi.com/2076-3417/9/22/4967
See also:
IVUS-guided vs coronary angiography-guided PCI in patients with AMI: A systematic review and meta-analysis
pubmed.ncbi.nlm.nih.gov/3504…
IVUS–Guided or Angiography-Guided Complex PCI
nejm.org/doi/10.1056/NEJMoa2…
Isaac Tea retweeted
Fantastic @HMethodistCV Grand Rounds by @RyanTedfordMD on RV reserve. Watch here: youtube.com/watch?v=HTyZyoPW….
Join @DeBakeyCVedu tomorrow at the George P. Noon Heart Failure Symposium to learn more from him and other leaders in the field of #LVAD.
Register learn.houstonmethodist.org/g…
Isaac Tea retweeted
Pt with critical PVD transferred for high risk PCI. Calcified LM, LCx ACS, RCA CTO, low EF, MR, now stable on heparin. @MCGCardFellows #ACCFIT
Isaac Tea retweeted
#ESCCongress @escardio @EAPCIPresident @ESC_President @Steph_Achenbach @alaide_chief
🛑 STOP-DAPT3 Trial
The aspirin-free strategy compared w the DAPT strategy failed to attest superiority for major bleeding within 1 month after PCI & was associated with a signal suggesting an excess of coronary events.
DAPT w aspirin & a P2Y12 inhibitor would still remain the standard strategy at least for 1 month after PCI.
🔅Heterogeneous group includes ACS
🔅>90% IVUS/OCT use
🔅Signal to higher stent thrombosis & MI
@DFCapodanno @DocSavageTJU @CMichaelGibson @drptca @fischman_david @cardioPCImom @Pooh_Velagapudi @Drroxmehran
@charles_driving @sbrugaletta @VDelgadoGarcia @DavidDuncker
@CMichaelGibson
@HanCardiomd @jozinetm
@m4ggiesimpson
@ARakisheva @WilfriedMullens
