A robot can technically do steps of a #TAVR, but to have the ability to critically think, evaluate, predict complications, treat complications, and take long term responsibility is another level. TAVR is an advanced #cardiac procedure for trained doctors, not ARNPs #CardioTwitter

🧵1/ With patient permission. This is one of our I6 PGY2s (right) doing a mitral repair, a superb PA (left) is assist and an attending is 2nd assist. A resident anesthesiologist is at bedside. Many patients wonder how residents participate in their care. One asked this week:

Leadless cath lab suits! #radialfirst

Happy to announce I performed Jamaica’s first ever #Tavr for treatment of aortic stenosis. Looking forward to continue to bring new minimally invasive cardiac therapies to the Caribbean. Medtronic Structural Heart Medtronic Medtronic Cardiac Jamaica Observer Shaun Smithson, MD FACC FSCAI #jamaica #doctor

Whoa, when the RV lead goes through the PFO into the LV 😂 #EPeeps #PFO #echofirst #radialfirst #cardioEd #CardioTwitter

Good morning Seattle! Here for the CRF Complications course! Adam Hafeez #radialfirst #CardioTwitter

Kidney 👏 function 👏 in 👏 acute 👏 HF 👏 is 👏 determined 👏 by 👏 CVP 👏 not 👏 cardiac 👏 output NEVER give IV fluids to a HF patient with renal failure unless you’ve checked congestion (echo cath Swan whatever)

Evolut vs Sapien. Dr Shah's algorithm for valve selection for #TAVR #cardiotwitter #radialfirst #cardioED #echofirst #BWH #wondrmedical

CMS finally states "CAS and CEA are similarly effective in patients with either standard or high surgical risk, and who are symptomatic with carotid artery stenosis ≥ 50% or asymptomatic with stenosis ≥ 70%" There's a place for TCAR, CEA and CAS. tctmd.com/news/cms-issue…

Goodbye little friend. Fare well and hope to see you again someday!😥 #xitter #RIPTwitterBird #RIPTwitter #ufoX

Great #TEER case with TSP facilitated with first #SafeCross use in Virginia! Steerable balloon tipped catheter with RF energy puncture. Safe, simple, speedy and successful. Thank you East End Medical Brij Maini MD for bringing this ingenious device to market! #CardioTwitter

This 6mm beauty was my first PCI as an attending.

Mortgage interest rate passed 8%, highest levels seen since late 2000. #market #news

NPO after midnight for a heart cath may soon be outdated business. We don't do it for STEMI patients. Study shows no harm and happier patients tctmd.com/news/no-fastin… #radialfirst #PCI #CardioTwitter #Cardiology #catheterization #NPO

Chest X-rays are powerful tools and often overlooked in era of CT imaging. Kerley B lines suggest CHF and or mitral stenosis. Termed by Irish radiologist James Kerley in 1933. And I got to treat one of his family members. #history #medtwitter #CardioTwitter #CXR #CHF #smallworld

“Every time we step in to save a life, we are exposing ourselves to potential harmful effects of ionizing radiation.” -David Rizik, on PBS special on cath lab radiation. #CardioEd #CardioTwitter #cath #cathlab #Cardiology tctmd.com/news/hot-doc-r…

Before Angioseal and Mynx, it was this guy. #sandbag #cardiotwitter #groin #cathlab #radialfirst

Iliac artery CTOs were previously a surgical fem-fem bypass, but now we are reconstructing legs without the need for open surgery. Dual femoral access, human floss, shockwave lithotripsy and Viabahn endograft. One hour of work. Outpatient procedure #endovascularfirst #savinglimbs