Evandro Martins F. MD

@evandrofilhobr • 20,787 subscribers

🇧🇷 Interventional Cardiologist | #RadialFirst #CTO #ImageFirst | Complex PCI & Structural Heart | Sharing cases, science & passion

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Junior rota-operator was starting this case under my supervision, after burr was advanced I noticed this...and immediately warrant him to stop. Correction was done and case went smoothly.

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Nice TAVR result in a very small anatomy but vascular access complication.

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#CTO101 72M, large burden ischemia @ anterior wall & CCS II-III angina despite OMT LAD CTO - blunt (some ambiguity) & calcium chunk How would you tackle this?

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$Protruding aorto-ostial stents can preclude safe TAVR. The RASE technique, integrating reverse hairpin re-entry, intentional fracture & snare extraction, offers a out-of-the-box controlled solution. Honored to contribute to this work in JACC Journals Case Reports with Raghav Gattani et al.$

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Evandro Martins F. MD

Shorts

Junior rota-operator was starting this case under my supervision, after burr was advanced I noticed this...and immediately warrant him to stop. Correction was done and case went smoothly.

Nice TAVR result in a very small anatomy but vascular access complication.

#CTO101 72M, large burden ischemia @ anterior wall &amp; CCS II-III angina despite OMT LAD CTO - blunt (some ambiguity) &amp; calcium chunk How would you tackle this?

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Watch Anya Live

Protruding aorto-ostial stents can preclude safe TAVR. The RASE technique, integrating reverse hairpin re-entry, intentional fracture & snare extraction, offers a out-of-the-box controlled solution. Honored to contribute to this work in JACC Journals Case Reports with Raghav Gattani et al.

Patient at home using a 24h Holter monitor. Trace reading after his death.

Shocking news. Looks like Damar Hamlin suffered a commotio cordis. Hope he recovers asap.

RCA CTO w/ ambiguous proximal cap. Knuckle wire advanced subintimally and probably inadvertently tracked an RV marginal branch, exploding... Luckily, perforation was into the RV cavity. No pericardial effusion, no tamponade. No need this time but always have echo + pericardiocentesis kit ready.

How would you manage this?

47🤠, symptomatic with an abnormal stress test (treadmill test - CP &amp; ST depression at peak exercise). following angiogram... What are your next steps for evaluating this patient?

85F. Double occlusions RCA &amp; LAD. CMR with heavy burden ischemia. Target was RCA, 1ry retro due px cap ambiguity using AV epicardial channel. Device uncrossable lesion after wire IP crossing. Grenadoplasty. IVUS &amp; CB for plaque modification.

My worst nightmare in the last 10 years practicing interventional cardiology. Annular rupture during TAVR with BEV. Emergent surgery was triggered but the patient couldn’t get out of extracorporeal circulation after valve replacement.

Satuday mood. 93 👨🏼‍🦳 very active, 3 hospitalizations for recurrent angina refractory to optimal medical tx. Normal EF. How would you approach?

16👨‍🦰, complex ASD anatomy (very floppy rims, aneurismatic septum &gt;10mm, absence of aortic rim). Failed attempt of percutaneous closure. ASD18 embolization (33/29 LA/RA discs) to the aortic arch. Successful snaring from the pin-hub after 2h trial. Upsized to 16F arterial sheath.

Sometimes we must take calculated risks to achieve good outcome — as long as every step is carefully planned. 🔹 Proximal LAD CTO opened retrogradely through patent LIMA. 🔹 Distal LAD collaterals used for RCA CTO retrograde recanalization. When there’s no easy way, build one!

#CTO101 #HDR #CTOPCI Interesting RCA CTO PCI Salman Arain maybe I get honor to get your inputs in this case... Still don't know how to name the crossing technique lol !😅 (I'm sure the patient don't care!)

Do you #imagefirst your STEMI's cases? Trivial case. 57M - LAD STEMI while playing soccer Thrombectomy - TIMI 3 flow - IVUS - Stent - then following IVUS. We must strive &amp; seek long-term results even in acute settings P.S.: this isn't good...

There’s no free lunch…😅 ROTAMONSTER

#CTO101 72M, large burden ischemia @ anterior wall & CCS II-III angina despite OMT LAD CTO - blunt (some ambiguity) & calcium chunk How would you tackle this?

47🤠, symptomatic with an abnormal stress test (treadmill test - CP & ST depression at peak exercise). following angiogram... What are your next steps for evaluating this patient?

85F. Double occlusions RCA & LAD. CMR with heavy burden ischemia. Target was RCA, 1ry retro due px cap ambiguity using AV epicardial channel. Device uncrossable lesion after wire IP crossing. Grenadoplasty. IVUS & CB for plaque modification.

16👨‍🦰, complex ASD anatomy (very floppy rims, aneurismatic septum >10mm, absence of aortic rim). Failed attempt of percutaneous closure. ASD18 embolization (33/29 LA/RA discs) to the aortic arch. Successful snaring from the pin-hub after 2h trial. Upsized to 16F arterial sheath.

Do you #imagefirst your STEMI's cases? Trivial case. 57M - LAD STEMI while playing soccer Thrombectomy - TIMI 3 flow - IVUS - Stent - then following IVUS. We must strive & seek long-term results even in acute settings P.S.: this isn't good...