'Nailing' of ostial LAD gone wrong 😢

Patient had PCI to LAD somewhere, but sx never improved, now coming in for 2nd opinion. What would u do now?

📌Teaching point for #ACCFIT : PCI of true ostial LAD lesion 👉 cross over to LMCA, & use imaging.

#CardioTwitter #Cardiology

45👨 w HTN. Asymptomatic.
👁️ #EchoFirst ➡️ PV = 3 m/s (descending Ao)
🎯 #YesCCT ➡️CoA
🪡Invasive P-P gradient=10 mmHg

➰3 Qs
1. Why are Echo & Cath gradients discordant?
2. Post-stenotic dilation or just aortopathy?
3. Management (Ao appears infolded)?

#CardioTwitter #ACCFIT

These cases are becoming more frequent

66F w poorly controlled DM & lipids

EF ok
CAD w CTO RCA & diseased LCX

⛔️ No access: both iliacs occluded, both radials & ulnars inaccessible w US guidance (before u ask yes got anesthesiologists to assist)..managed the brachial

Beyond…

Aditya Bharadwaj CircInterventions David J. Cohen, MD, MSc Alex Truesdell Alejandro Lemor MD, MS Poonam Velagapudi Ankitkumar Patel MD MPH FACC FSCAI RPVI Haroon Faraz Sunil V. Rao J Dawn Abbott Allison Dupont, MD Saraschandra Vallabhajosyula, MD MSc Really important work Aditya! ESRD will likely be the #1 reason for exclusion from Protect IV and therefore we will have to rely on observational data when treating this complex patients!

Bold step forward in JAMA today.

A viewpoint describing whether and when causal language can be used to describe the intent and results of observational studies.

Led by BIDMC Smith Center and CAUSALab epidemiologist Issa Dahabreh.

jamanetwork.com/journals/jama/…

What’s going on with the interatrial septum? 👀

#CardioTwitter #Cardiology #ACCFIT #EchoFirst BCM Cardiology #MedTwitter American Society of Echocardiography Aga Khan University American College of Cardiology Texas Chapter - ACC

Congratulations, Aditya and team! #CardioTwitter #CKD #HRPCI #pVAD #ACCIC #ACCFIT #ACCEarlyCareer

Addressing a limitation in most studies!

ESRD & eGFR<30 (functionally renal failure) ⬆️⬆️ risk of MACE and all-cause mortality w/ hrPCI (though no diff in procedural complications, pt substrate?)

Importantly, GFR >30 ~ no significant difference in outcomes at 1yr

CircInterventions

Impact of coronary sinus reducer on absolute coronary blood flow and microvascular resistance

🔺What are the mechanisms ❓

🔺What is the impact on microvascular dysfunction ❓

🔺Could further angina relief be
expected after endothelialization❓

🔗 onlinelibrary.wiley.com/doi/full/10.10…

So honored to be awarded with #scai2024 ‘s 30 early career interventional cardiologists in their 30s. Grateful to my family and mentors who have supported me through this journey and have fostered my growth SCAI Now
MIЯVΛƬ #IC

#maythe4thbewithyou 💃🏽👩🏻‍⚕️❤️

Great time catching up with Kashish Goel & Sukhdeep Singh Basra - reminiscing how our journeys overlapped in residency and before!
Pooja Swamy, MD, FACC, FSCAI SCAI Now

Wonderful seeing Rajiv Jauhar although for a quick minute!
#SCAI2024

Celebrating our second class of SCAI's 30 in Their 30s recipients, an annual award that recognizes the accomplishments of early-career interventional cardiologists who have the qualities required to be one of the field's future leaders. #SCAI2024

Great session on complex interventional cases- excellent discussions by a stellar panel! Rajiv Gulati Katherine Kunkel, MD, MSEd Rajiv Jauhar Ankitkumar Patel MD MPH FACC FSCAI RPVI SCAI Now
#SCAI2024
Pooja Swamy, MD, FACC, FSCAI Poonam Velagapudi

Catching up with the pink trend - Srihari S. Naidu, MD has 🌸 on his tie #pinkICclub
MIЯVΛƬ #IC Mamas A. Mamas Poonam Velagapudi Jamal Rana, MD Ankitkumar Patel MD MPH FACC FSCAI RPVI Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Dr Anastasia Mihailidou FAHA FCSANZ FESC
#SCAI2024

Aditya Bharadwaj Srihari S. Naidu, MD Pooja Swamy, MD, FACC, FSCAI SCAI Now Mamas A. Mamas Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 MIЯVΛƬ #IC Poonam Velagapudi Hany Ragy This photo brings a smile to my face. Srihari S. Naidu, MD & Aditya Bharadwaj You are both brilliant & positive. Lucky to have found my way to become your friend. Next time I will be in that photo American College of Cardiology

#SCAIShock2024 chair interview with Chadi Alraies, MD FACC FSCAI discussing what is in the works for the meeting Oct. 17-19 in Washington D.C. Save the date! It’s a conference you don’t want to miss.SCAI Now Babar Basir Sandeep Nathan, MD, MSc