“Fast is slow, slow is smooth, smooth is fast”.

A🧵for interventional cardiology #ACCFIT You’re likely to hear a variation of this phrase during your training in the cath lab. So what does it mean? And why do interventional cardiologists find it so compelling?

Let’s break it down.

@MusaSharkawi @ashkumar513 @iamritu @DavidWienerMD @bcostelloMD @onco_cardiology @majazayeri @IngrassiaMD I think this deserves a more detailed explanation. I’ve heard the “deficient rims” label in the PFO space a lot recently. Rims should not be part of the PFO closure discussion - but it shows up from time to time. Let’s dig deeper. 1/ @MusaSharkawi @ashkumar513 @iamritu @DavidWienerMD @bcostelloMD @onco_cardiology @majazayeri @IngrassiaMD 2/ Anatomy first. This will be Oversimplified, so forgive me (this is Twitter after all). IAS consists of septum primum and septum secundum. Fossa ovalis (here labeled oval foramen) is soft part of IAS where we puncture septum in Structural procedures.