Ashish Pershad Profile picture
Jun 10, 2020 8 tweets 6 min read Read on X
#cardiotwitter -need help how would you manage this case. Attempting in 2 hours. EF normal and advanced Parkinson’s 68 yr old male @rwyeh @DKarmpaliotis @ajaykirtane @JAG24851 @mmamas1973
1- support no support 2-bifurcation strategy
1-safe femoral (sorry #radialfirst) 8fr 2-Filling pressures high so Support-(sorry #impella haters)
3-1.5 and 2mm burr into LAD
4-1.5mm burr in Cx
5-4mm Onyx LAD LMT
6-POT 5mm - IVUS
7-4mm Onyx into CX (TAP)
8- FKB final IVUS
9-Pump out (1 perclose)
Opinion solicited on strategy to manage coronary obstruction risk @SusheelKodaliMD @GilbertTangMD @PaulMahoneyMD @sameergafoor @tavrkapadia @TAVRBot @CathElectroSurg @AdamGreenbaumMD
-Annulus 380mm
-LM height 10mm
-STJ diameter 24
-STJ height 16
-LCC length 12.6
-SOV 25mm
Here are some pics as @sameergafoor @GilbertTangMD wanted ImageImageImage

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More from @AshishPershad

Sep 24, 2020
Post infarct apical VSD closure -2 weeks post anterior mi and 1 week on IABP with no end organ damage- self selection
Read 11 tweets
Jun 2, 2020
Tweetorial on Reverse Basilica (tip to base)
56 yr old with prior MVR Theon 29mm in 2015. Severe mitral stenosis and Sec pulm hypertension (70-80mm Hg). NeoLVOT 1.1 cm squared with 29 S-3 with 20% atrial offset
Read 14 tweets
Apr 27, 2020
Sequela of #COVID19 is late presentation of MIs causing VSD. Follow the thread for a VSD closure that we did today @BannerHealth 1/n
Echo showing basal VSD Qp/Qs of 2.3 -- cardiogenic shock. IRA is RCA 2/n
Big hole on the LV side -- serpiginous tract with smaller hole on the RV side 3/n
Read 12 tweets
Sep 11, 2019
Basilica tweetorial- step 1 Sentinel TRA
Step 2-6fr MP guide via Contra femoral across mitraflow 19 mm valve into left ventricle with 0.018 platinum plus wire in LV
Step3-20 mm Ensnare in left ventricle through MP guide with AL3 cath in root thro 14 Fr dry seal sheath via RFA
Read 12 tweets
Apr 9, 2019
Post infarct apical VSD closure -step1 3D print Image
Step2-define location on angio in LAO cranial angulation
Step3 -identify VSD on echo
Read 10 tweets

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