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🔹What will be ur approach for this #PCI? 📌Transferred from OSH with this angio. Presented with HF now optimized. 📌82M, significant LMB stenosis, RCA #CTO, LVEF 10-15%, PAD. Turned down for #CABG #CardioTwitter #Cardiology #ACCFIT European Bifurcation Club BCM Cardiology AKUCardiology

12,575 次观看 • 2 年前 •via X (Twitter)

10 条评论

Nyal Borges 的头像
Nyal Borges2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Impella supported pci LMT-LAD. med Rx all else. Try to keep it simple as much as possible. Only clear benefit is likely angina relief. Maybe less HF episodes triggered by ischemia. No mortality benefit in an 82yo as much as you can predict - already past average life expectancy.

Benjamin K.M 的头像
Benjamin K.M2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Learning so much from your cases, thank you!

Umair Khalid 的头像
Umair Khalid2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Thank you. I learn so much for #cardiotwitter friends everyday!

Pardha Saradhi Sivakoti 的头像
Pardha Saradhi Sivakoti2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Impella assisted PCI from LM to LAD with Rota/IVL, Spot stenting of LCX and DEB to ramus

Umair Khalid 的头像
Umair Khalid2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Great thoughts. Thanks. We do not have DEB yet at our institution.

Antonious Attallah, MD, FACC, FSCAI 的头像
Antonious Attallah, MD, FACC, FSCAI2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @Almanfi_Cardio @evandrofilhobr Upfront MCS. Fix the circ proper first. Dk crush large ramus into Lm-lad. Latter will require atherectomy +\- IVL. In an 82 yo would treat RC medically for now. Quad therapy as hard as you can for HFrEF. All IVI guided of course.

Joy Sanyal,MD, DM, 的头像
Joy Sanyal,MD, DM,2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Stabilise,MCS ,Rota LM,prepare Cx and RI may be DCB -provisional LM LAD

Dr Why 的头像
Dr Why2 年前

@BifurcationClub @BCMHeart @AkuCardiology @mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Med rx if no angina

jedicath աǟզǟʀ.ǟɦʍɛɖ 的头像
jedicath աǟզǟʀ.ǟɦʍɛɖ2 年前

@mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr Agree with the surgeons. Will any revascularization change the prognosis. If Angina then needs a convo with the patient

Umair Khalid 的头像
Umair Khalid2 年前

@mmamas1973 @adityadoc1 @Pooh_Velagapudi @JingLiu_MD @minhaskh @BakhshiHooman @HadyLichaaMD @AntoniousAttall @Almanfi_Cardio @evandrofilhobr He has both angina + HF. Had multiple long discussions with the patient & family now plan for high risk PCI (shared decision making). What % risk of major complications would u quote during discussion with the patient?

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