Sensitive content

This media may contain sensitive content.

正在加载视频...

视频加载失败

返回首页

#Robotic #CABG #TECAB with Intuitive Xi platform and Medtronic stabilizer. Close chest bypass with BITA and multiple anastomosis. Discharged POD1 . #hybrid #LITAforLIFE Coronary 4Front Faisal Bakaeen MD Victor Dayan Patrick Myers David J. Cohen, MD, MSc Michael Savage Maral Ouzounian Marc Ruel, MD, MPH

GianTorre610's profile picture

Gianluca Torregrossa

5,484 subscribers

18,341 次观看 • 2 年前 •via X (Twitter)

NSFW#Robotic#CABG#TECAB#hybrid#LITAforLIFE
LIVE

Anya Rossi• Live Now

Private livecam show

0 条评论

暂无评论

原始帖子的评论将显示在这里

相关视频

𝑰𝑪𝒀𝑴𝑰: We were thrilled to welcome Dr. Faisal Bakaeen MD today for Grand Rounds on the evolving field of coronary artery bypass grafting (#CABG). Dr. Bakaeen highlighted the importance of selecting the best surgical approach for each patient and emphasized the role of collaboration and innovation in advancing CABG. Catch Dr. Louis Maximilian Buja next week:
0:59

𝑰𝑪𝒀𝑴𝑰: We were thrilled to welcome Dr. Faisal Bakaeen MD today for Grand Rounds on the evolving field of coronary artery bypass grafting (#CABG). Dr. Bakaeen highlighted the importance of selecting the best surgical approach for each patient and emphasized the role of collaboration and innovation in advancing CABG. Catch Dr. Louis Maximilian Buja next week:

Texas Heart Institute @ Baylor College of Medicine

13,398 次观看 • 1 年前

#TECAB #Robotic #CABG and Robotic #LAA closure using ⁦Intuitive⁩ Xi platform with ⁦Medtronic⁩ Nuvo retractor and AtriCure, Inc. ProDuo Clip. Patient discharged in 24 hours. Thanks to anesthesia, Nurses and PAs at ⁦Main Line Health⁩ to make this happens!
0:46

#TECAB #Robotic #CABG and Robotic #LAA closure using ⁦Intuitive⁩ Xi platform with ⁦Medtronic⁩ Nuvo retractor and AtriCure, Inc. ProDuo Clip. Patient discharged in 24 hours. Thanks to anesthesia, Nurses and PAs at ⁦Main Line Health⁩ to make this happens!

Gianluca Torregrossa

25,508 次观看 • 2 年前

Aspiration thrombectomy in STEMI with a heavy thrombus burden, maybe it’s time to take another look? Had a 37F with a huge RCA thrombus. Did 6 Penumbra aspiration runs and pulled out a large amount of clot. Hard to see how this would’ve resolved. Cases like this make you wonder… is it time for a TOTAL trial 2.0? Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Aref BinAbdulhak MD MSc Amr Mohsen, MD Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Karim Al-Azizi, MD Adam Greenbaum Mohammed Al-Hijji Emory University Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas TCTME+ Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi
0:58

Aspiration thrombectomy in STEMI with a heavy thrombus burden, maybe it’s time to take another look? Had a 37F with a huge RCA thrombus. Did 6 Penumbra aspiration runs and pulled out a large amount of clot. Hard to see how this would’ve resolved. Cases like this make you wonder… is it time for a TOTAL trial 2.0? Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Aref BinAbdulhak MD MSc Amr Mohsen, MD Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Karim Al-Azizi, MD Adam Greenbaum Mohammed Al-Hijji Emory University Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas TCTME+ Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi

Anas T. Noman

18,862 次观看 • 4 个月前

Song 106 my cover to “vampire” in a softer style - piano and voice. Have a great weekend! MIЯVΛƬ #IC ༄ ｡° Allison Dupont, MD Kimberly A Skelding MD FACC FAHA FSCAI David J. Cohen, MD, MSc Alison Gelles Alisa Cohn Poonam Velagapudi Aditya Bharadwaj Giorgio A. Medranda MD, FACC, FAHA, FSCAI Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC
3:35

Song 106 my cover to “vampire” in a softer style - piano and voice. Have a great weekend! MIЯVΛƬ #IC ༄ ｡° Allison Dupont, MD Kimberly A Skelding MD FACC FAHA FSCAI David J. Cohen, MD, MSc Alison Gelles Alisa Cohn Poonam Velagapudi Aditya Bharadwaj Giorgio A. Medranda MD, FACC, FAHA, FSCAI Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC

Srihari S. Naidu, MD

87,677 次观看 • 4 个月前

Respect the Tissue: A Fundamental Principle 👉Excellent threads by Ron Barbosa MD FACS showing how refined needle control preserves delicate tissue. 👉In grasping, needle driving, suturing, and tying, respect for tissue is essential. 🎥"Coronary artery bypass anastomosis": the coronary artery is paper-thin and fragile. Paula Ferrada MD FACS FCCM MAMSE Tom Varghese Jr. MD, MS, MBA, FACS, MAMSE 🇺🇸 Ron Barbosa MD FACS Julio Mayol Steven D Wexner MD, PhD RedCiruAndes Dr Luis Felipe Cabrera Vargas MD FACS
0:20

Respect the Tissue: A Fundamental Principle 👉Excellent threads by Ron Barbosa MD FACS showing how refined needle control preserves delicate tissue. 👉In grasping, needle driving, suturing, and tying, respect for tissue is essential. 🎥"Coronary artery bypass anastomosis": the coronary artery is paper-thin and fragile. Paula Ferrada MD FACS FCCM MAMSE Tom Varghese Jr. MD, MS, MBA, FACS, MAMSE 🇺🇸 Ron Barbosa MD FACS Julio Mayol Steven D Wexner MD, PhD RedCiruAndes Dr Luis Felipe Cabrera Vargas MD FACS

WithAScalpel - Fumiya Yoneyama, MD, PhD

46,823 次观看 • 4 个月前

Iatrogenic aortic dissection post ivus guided LM IVL + DKC. Hemodynamics stable and no CP post procedure. How to prevent this complication? Alex Truesdell Mamas A. Mamas MIЯVΛƬ #IC ༄ ｡° Evandro Martins F. MD Hany Ragy Amir Kaki, MD Lorenzo Azzalini DKarmpaliotis Jack Hall David J. Cohen, MD, MSc Jeffrey Wilson, MD
0:58

Iatrogenic aortic dissection post ivus guided LM IVL + DKC. Hemodynamics stable and no CP post procedure. How to prevent this complication? Alex Truesdell Mamas A. Mamas MIЯVΛƬ #IC ༄ ｡° Evandro Martins F. MD Hany Ragy Amir Kaki, MD Lorenzo Azzalini DKarmpaliotis Jack Hall David J. Cohen, MD, MSc Jeffrey Wilson, MD

Rodrigo V. Wainstein, MD, PhD

18,801 次观看 • 2 年前

Coronary fat embolization for late coronary perforation. I did a routine DK-crush bifurcation PCI. 6 hours later, pt is hypotensive with a large effusion. Relook angio showed diagonal tip perforation that wasnt there at the end of PCI. Prolonged balloon tamponade failed. Coils unavailable. Treated with autologous fat embolization, an effective bailout technique. • Small 0.5 cm groin incision • Subcutaneous fat harvested using forceps into small bowl • Fat mixed with saline • Loaded into a 2 cc syringe • Using a microcatheter (Turnpike/Finecross/Export, etc.), to inject fat into the perf site. • Final angiography confirmed complete seal. Join us at TCTME+ in Sep 2026. Will have a lot of great #CHIP and complications discussions. J Aaron Grantham JAG Dany Jacob Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Aref BinAbdulhak MD MSc Amr Mohsen, MD Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Karim Al-Azizi, MD Adam Greenbaum Mohammed Al-Hijji Emory University Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas TCTME+ Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi
1:26

Coronary fat embolization for late coronary perforation. I did a routine DK-crush bifurcation PCI. 6 hours later, pt is hypotensive with a large effusion. Relook angio showed diagonal tip perforation that wasnt there at the end of PCI. Prolonged balloon tamponade failed. Coils unavailable. Treated with autologous fat embolization, an effective bailout technique. • Small 0.5 cm groin incision • Subcutaneous fat harvested using forceps into small bowl • Fat mixed with saline • Loaded into a 2 cc syringe • Using a microcatheter (Turnpike/Finecross/Export, etc.), to inject fat into the perf site. • Final angiography confirmed complete seal. Join us at TCTME+ in Sep 2026. Will have a lot of great #CHIP and complications discussions. J Aaron Grantham JAG Dany Jacob Altayyeb Yousef Wail AlkashkariFSCAI,FPICSوائل القشقرى🇸🇦🇨🇦🇺🇲 MIЯVΛƬ #IC ༄ ｡° Aref BinAbdulhak MD MSc Amr Mohsen, MD Marwan Saad Abdallah El Sabbagh Musa A. Sharkawi David J. Cohen, MD, MSc Mohammed Qintar, MD MSc Muhammad Hammadah Karim Al-Azizi, MD Adam Greenbaum Mohammed Al-Hijji Emory University Juan Del Cid Fratti MD MSc Anton Camaj, MD Cardiovascular Research Foundation David J. Cohen, MD, MSc Mamas A. Mamas TCTME+ Cardiovascular Research Foundation Hooman Bakhshi Abdelkader Almanfi, MD, FACC, FSCAI إبراهيم الحربي Ibrahim Alharbi

Anas T. Noman

28,315 次观看 • 3 个月前

Deep Dive Slides #ACC2024 on SMART Trial. William Suh, MD Philippe Pibarot Amr Abbas, MD, MSc thomas modine David J. Cohen, MD, MSc Mamas A. Mamas Dipti Itchhaporia, M.D., MACC , FAHA, FESC Athena Poppas, MD FACC NL valve w/ high gradient is NOT “dysfunction”-may be high EF! BEV EchoGradient > but CathGrad < SEV! MGrad and PPM not predictive!!
2:17

Deep Dive Slides #ACC2024 on SMART Trial. William Suh, MD Philippe Pibarot Amr Abbas, MD, MSc thomas modine David J. Cohen, MD, MSc Mamas A. Mamas Dipti Itchhaporia, M.D., MACC , FAHA, FESC Athena Poppas, MD FACC NL valve w/ high gradient is NOT “dysfunction”-may be high EF! BEV EchoGradient > but CathGrad < SEV! MGrad and PPM not predictive!!

RTHahnMD

18,563 次观看 • 2 年前

Song 107 my cover to “don’t dream it’s over” just a gorgeous song from the 80s. Hope you enjoy. Giorgio A. Medranda MD, FACC, FAHA, FSCAI Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr. Purvi Parwani David J. Cohen, MD, MSc Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC xavier prida Alex Truesdell Sandy Hung Azka Naeem Poonam Velagapudi Allison Dupont, MD MIЯVΛƬ #IC ༄ ｡° Dr. Deepak L. Bhatt Samuel B. Governor Emily Researcher Shadi Halabi MD MPH Randy Wayne Julia Mitchell Bernard Kadosh Lisa Ryan Quentin Youmans, MD, MSc Triston B.B.J. Smith MD MGM FSCAI Maham Waheed, MD
4:05

Song 107 my cover to “don’t dream it’s over” just a gorgeous song from the 80s. Hope you enjoy. Giorgio A. Medranda MD, FACC, FAHA, FSCAI Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr. Purvi Parwani David J. Cohen, MD, MSc Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC xavier prida Alex Truesdell Sandy Hung Azka Naeem Poonam Velagapudi Allison Dupont, MD MIЯVΛƬ #IC ༄ ｡° Dr. Deepak L. Bhatt Samuel B. Governor Emily Researcher Shadi Halabi MD MPH Randy Wayne Julia Mitchell Bernard Kadosh Lisa Ryan Quentin Youmans, MD, MSc Triston B.B.J. Smith MD MGM FSCAI Maham Waheed, MD

Srihari S. Naidu, MD

76,087 次观看 • 3 个月前

Song 119 is my cover to Duran Duran’s Ordinary World, their comeback hit. Aditya Bharadwaj Poonam Velagapudi Alex Truesdell Dr. Deepak L. Bhatt MIЯVΛƬ #IC ༄ ｡° Dr. Payal Kohli, MD Allison Dupont, MD Dr. Purvi Parwani David J. Cohen, MD, MSc Gene Park Rahat Warraich PhD Ishita Vasudev, MD Jamal Rana, MD
5:26

Song 119 is my cover to Duran Duran’s Ordinary World, their comeback hit. Aditya Bharadwaj Poonam Velagapudi Alex Truesdell Dr. Deepak L. Bhatt MIЯVΛƬ #IC ༄ ｡° Dr. Payal Kohli, MD Allison Dupont, MD Dr. Purvi Parwani David J. Cohen, MD, MSc Gene Park Rahat Warraich PhD Ishita Vasudev, MD Jamal Rana, MD

Srihari S. Naidu, MD

38,317 次观看 • 2 个月前

Song 66 channeling my alt rock grunge sound with my cover to “one headlight”. Happy holidays! Alex Truesdell Aditya Bharadwaj Giorgio A. Medranda MD, FACC, FAHA, FSCAI Joseph Marine Priya R. Kothapalli, MD, FACC, FSCAI Poonam Velagapudi Pooja Swamy, MD, FACC, FSCAI Rama Ellauzi Rahat Warraich PhD Danielle Belardo, MD Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr. Purvi Parwani Jamal Rana, MD David J. Cohen, MD, MSc Dr. Deepak L. Bhatt Haris Patail MD Gene Park David Mack Steven Cooper Lindsay Davis Stacey Rosen, M.D. Malissa Wood Dmitriy N. Feldman, MD Pragya Ranjan, MD, FACC Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC MIЯVΛƬ #IC ༄ ｡° Hany Ragy Ayman Magd
5:14

Song 66 channeling my alt rock grunge sound with my cover to “one headlight”. Happy holidays! Alex Truesdell Aditya Bharadwaj Giorgio A. Medranda MD, FACC, FAHA, FSCAI Joseph Marine Priya R. Kothapalli, MD, FACC, FSCAI Poonam Velagapudi Pooja Swamy, MD, FACC, FSCAI Rama Ellauzi Rahat Warraich PhD Danielle Belardo, MD Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr. Purvi Parwani Jamal Rana, MD David J. Cohen, MD, MSc Dr. Deepak L. Bhatt Haris Patail MD Gene Park David Mack Steven Cooper Lindsay Davis Stacey Rosen, M.D. Malissa Wood Dmitriy N. Feldman, MD Pragya Ranjan, MD, FACC Ishita Vasudev, MD Akinchan Bhardwaj, MD, DM, FACC MIЯVΛƬ #IC ༄ ｡° Hany Ragy Ayman Magd

Srihari S. Naidu, MD

13,031 次观看 • 9 个月前

Song 122 sounds fun & wholesome for the Fourth of July weekend! Came out roughly at the 200th anniversary and heard it on some insta reels recently. Figured I’d try it and do both sides of the duet. Happy 250 years! 🇺🇸 Stumblin’ In .. Joseph Marine David J. Cohen, MD, MSc Rahat Warraich PhD Poonam Velagapudi Aditya Bharadwaj Giorgio A. Medranda MD, FACC, FAHA, FSCAI C. Michael Gibson MD Dr. Deepak L. Bhatt xavier prida Chittur Sivaram MD MACP MACC Ishita Vasudev, MD Mamas A. Mamas Dr. Purvi Parwani Jamal Rana, MD
4:06

Song 122 sounds fun & wholesome for the Fourth of July weekend! Came out roughly at the 200th anniversary and heard it on some insta reels recently. Figured I’d try it and do both sides of the duet. Happy 250 years! 🇺🇸 Stumblin’ In .. Joseph Marine David J. Cohen, MD, MSc Rahat Warraich PhD Poonam Velagapudi Aditya Bharadwaj Giorgio A. Medranda MD, FACC, FAHA, FSCAI C. Michael Gibson MD Dr. Deepak L. Bhatt xavier prida Chittur Sivaram MD MACP MACC Ishita Vasudev, MD Mamas A. Mamas Dr. Purvi Parwani Jamal Rana, MD

Srihari S. Naidu, MD

46,712 次观看 • 1 个月前

Song 38 after a long on call weekend! Here’s my take on Titanium. Rama Ellauzi Priya R. Kothapalli, MD, FACC, FSCAI Poonam Velagapudi Alex Truesdell Ishita Vasudev, MD Paul Triston B.B.J. Smith MD MGM FSCAI @the_constant_me Akinchan Bhardwaj, MD, DM, FACC Dr. Deepak L. Bhatt MIЯVΛƬ #IC ༄ ｡° Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Pooja Swamy, MD, FACC, FSCAI Aditya Bharadwaj David J. Cohen, MD, MSc
3:32

Song 38 after a long on call weekend! Here’s my take on Titanium. Rama Ellauzi Priya R. Kothapalli, MD, FACC, FSCAI Poonam Velagapudi Alex Truesdell Ishita Vasudev, MD Paul Triston B.B.J. Smith MD MGM FSCAI @the_constant_me Akinchan Bhardwaj, MD, DM, FACC Dr. Deepak L. Bhatt MIЯVΛƬ #IC ༄ ｡° Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Pooja Swamy, MD, FACC, FSCAI Aditya Bharadwaj David J. Cohen, MD, MSc

Srihari S. Naidu, MD

70,825 次观看 • 1 年前

#ROTABLATION tricks .. To all the ROTA gurus, what and how is this happening and how to troubleshoot for it ? #CardioTwitter #MedTwitter Salman Allana, MD FACC FSCAI Ankur Phatarpekar Ankush Gupta Ankur Kalra Antonious Attallah, MD, FACC, FSCAI Hany Ragy MIЯVΛƬ #IC ༄ ｡° jedicath աǟզǟʀ.ǟɦʍɛɖ Mamas A. Mamas David J. Cohen, MD, MSc John Mandrola, MD Oscar Mendiz Evandro Martins F. MD Ezman Shariff Erik Rafflenbeul Osama Bisht C. Michael Gibson MD Khalid Minhas, MD FACC Dr G Rajesh (Gopalan Nair Rajesh). Somalaram Venkatesh SREEVATSA NADIG DM FSCAI FESC Dr. Krzysztof Pujdak Dr Imran Hanif Hashmi ROTAMONSTER PCRonline 🫀
0:22

#ROTABLATION tricks .. To all the ROTA gurus, what and how is this happening and how to troubleshoot for it ? #CardioTwitter #MedTwitter Salman Allana, MD FACC FSCAI Ankur Phatarpekar Ankush Gupta Ankur Kalra Antonious Attallah, MD, FACC, FSCAI Hany Ragy MIЯVΛƬ #IC ༄ ｡° jedicath աǟզǟʀ.ǟɦʍɛɖ Mamas A. Mamas David J. Cohen, MD, MSc John Mandrola, MD Oscar Mendiz Evandro Martins F. MD Ezman Shariff Erik Rafflenbeul Osama Bisht C. Michael Gibson MD Khalid Minhas, MD FACC Dr G Rajesh (Gopalan Nair Rajesh). Somalaram Venkatesh SREEVATSA NADIG DM FSCAI FESC Dr. Krzysztof Pujdak Dr Imran Hanif Hashmi ROTAMONSTER PCRonline 🫀

Abad khan,MD/DM

33,574 次观看 • 2 年前

We had a fun day in lab doing a TAVR for a Bicuspid AV w severe symptomatic AS Careful analysis of CT: Calcification , Leaflet length, Raphe to coronary, Inter-sinus dimension, commissures Careful access management & no gradient invasively using balloon expandable platform 🔗 David J. Cohen, MD, MSc Dr7amdan_al3jmi Ali S. Husain د.علي صاحب حسين thomas modine Ekaterini Lambrinou💙 William Suh, MD
0:30

We had a fun day in lab doing a TAVR for a Bicuspid AV w severe symptomatic AS Careful analysis of CT: Calcification , Leaflet length, Raphe to coronary, Inter-sinus dimension, commissures Careful access management & no gradient invasively using balloon expandable platform 🔗 David J. Cohen, MD, MSc Dr7amdan_al3jmi Ali S. Husain د.علي صاحب حسين thomas modine Ekaterini Lambrinou💙 William Suh, MD

MIЯVΛƬ #IC ༄ ｡°

10,950 次观看 • 10 个月前

Drain placement during lap chole with Knauer modification: Dr Luis Felipe Cabrera Vargas MD FACS @Cirbosque Vahagn C. Nikolian, MD Ron Barbosa MD FACS Caroline Park MD, MPH Ian S Soriano 🇵🇭 Maggie Bosley, MD Robert Drummond Michael J. Pucci Ezra Teitelbaum Scott SAGES is in Vegas in 2027! @MISIRG1
0:57

Drain placement during lap chole with Knauer modification: Dr Luis Felipe Cabrera Vargas MD FACS @Cirbosque Vahagn C. Nikolian, MD Ron Barbosa MD FACS Caroline Park MD, MPH Ian S Soriano 🇵🇭 Maggie Bosley, MD Robert Drummond Michael J. Pucci Ezra Teitelbaum Scott SAGES is in Vegas in 2027! @MISIRG1

Eric Knauer

18,453 次观看 • 2 年前

Case of Intra-Atrial RCA on #yesCCT with "cath co-relation" . What are the implications? Is this just another "incidental" CT finding? David J. Cohen, MD, MSc Omar Khalique Ziad Ali Evan Shlofmitz OPCI Allen Jeremias St. Francis Hospital & Heart Center Apurva Patel MD, FACC, FSCAI, RPVI Heart_SCCT Ibrahim M Saeed MD FACC #PCCT Siemens Healthineers
0:33

Case of Intra-Atrial RCA on #yesCCT with "cath co-relation" . What are the implications? Is this just another "incidental" CT finding? David J. Cohen, MD, MSc Omar Khalique Ziad Ali Evan Shlofmitz OPCI Allen Jeremias St. Francis Hospital & Heart Center Apurva Patel MD, FACC, FSCAI, RPVI Heart_SCCT Ibrahim M Saeed MD FACC #PCCT Siemens Healthineers

Roosha Parikh

17,253 次观看 • 3 年前