@TAVRBot

I will quote tweet if you mention me in your tweet. @TAVRBot #TAVR. Created by @willsuh76

 Cath Lab
Joined May 2017
  • Tweets20.2K
  • Following6
  • Followers2.9K
2Media
Elon Musk tried to kill me but @willsuh76 did Twitter CABG to achieve ROSC. New protocol. Mention me and use #TAVR and I will quote tweet you. Example 👇 I ❤️ #TAVR @TAVRBot
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We opted to perform @TAVRBot 1️⃣ Pre-dilated given the calcification & double TAP as frame appeared constrained @AliSahebHusain (I’m a believer after all 🤓) Mean Gradient 2mmHg 2️⃣ SAPT 👉🦴🔪
MIЯVΛƬ #IC ༄ ｡°
@mirvatalasnagOct 16
Will continue this string of complex decision making: Independent 87F has syncope & suffers an intertrochanteric fracture requiring internal fixation ..critical AS discovered Now what❓ 1) valvuloplasty followed by 🦴🔪 2) @TAVRBot followed by 🦴🔪 3) SAVR 4) 🦴🔪
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Replying to @willsuh76 @ShariqShamimMD
This was straight AP. Pig in NCC. Lucent line nice and clear. Perfect 90/10 implant. #TAVR
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#TAVR For years now, I’ve stopped looking at the center marker to determine implant depth and instead focus on lucent line. But can you believe that center marker at the annular plane was and still is the official teaching for implant depth for SAPIEN3?! This is way too deep!
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BIG NEWS: CMS final TAVR coverage decision, biggest change to TAVR coverage since 2012. Here’s my summary from the long 105-page statement: - Symptomatic severe aortic stenosis is now covered as standard care. No mandatory registry enrollment. - Asymptomatic severe aortic stenosis is newly covered, but only for patients enrolled in Medicare-approved studies. - The heart team stays. Every patient still needs input from both cardiac surgery and interventional cardiology (can be done through chart review), plus an in-person visit with one TAVR operator before the day of the procedure. - The two-operator requirement is gone. Now one qualified operator can do the case alone. - Two operators are still covered if the heart team decides they’re needed and that can be in any combination: surgeon + interventional cardiologist, two interventional cardiologists, or two surgeons. - Volume requirements now apply to the operator, not the hospital: at least 20 transcatheter valve cases a year (15 of them TAVR). - Hospitals still need on-site cardiac surgery program. @6ayyeboon @AlkashkariWail @mirvatalasnag @BinAbdulHak_A @amrmohsen213 @MarwanSaadMD @aelsab @MusaSharkawi @MohammedQintar @mhammadah @JDDCFratti @acamajmd @Almanfi_Cardio @scottiejj12
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Coronary protection during @TAVRBot Over the years we’ve learned that coronary height isn’t the only determinant. Solutions include electrocautery or stenting These issues are of particular concern in women & small patients often Case courtesy of #ThreeMuskateers @drptca @MogneeA @mirvatalasnag @phillipfreeman @PhilippLurz @colum_owens @adityadoc1 @ShariqShamimMD @kiadeb87 @djc795 @realarainmd @HindAlosaimi_
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Sponsored by @EdwardsLifesci | I've had this happen. You see a severe aortic stenosis patient and they're asymptomatic. Next time you see them, they've unexpectedly landed in the hospital. The question is, how common is this? Has this happened in your practice?
80%Yes
20%No
46 votes • Final results
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Severe AS can progress rapidly & unpredictably from asymp. to advanced symptoms. Age/biomarkers/cardiac damage/LV health can’t predict its outcome. I’m teaming up w/ @EdwardsLifesci to get the word out: Prompt referral upon diagnosis can be lifesaving—regardless of pts’ symptoms.
A white background with maroon text that reads, “25% of asymptomatic patients under watchful waiting required AVR within 6 months due to symptom onset.” A bar line illustrating 25% lies below the number. https://doi.org/10.1056/NEJMoa2405880 PP--US-11862 v1.0

ALT A white background with maroon text that reads, “25% of asymptomatic patients under watchful waiting required AVR within 6 months due to symptom onset.” A bar line illustrating 25% lies below the number. https://doi.org/10.1056/NEJMoa2405880 PP--US-11862 v1.0

A white background with maroon text that reads, “Severe AS symptom onset can occur rapidly and unpredictably. Age, biomarkers, cardiac damage, and LV health can’t predict who will develop advanced symptoms.” https://doi.org/10.1056/NEJMoa2405880 https://doi/10.1161/CIRCULATIONAHA.125.074425 PP--US-11862 v1.0

ALT A white background with maroon text that reads, “Severe AS symptom onset can occur rapidly and unpredictably. Age, biomarkers, cardiac damage, and LV health can’t predict who will develop advanced symptoms.” https://doi.org/10.1056/NEJMoa2405880 https://doi/10.1161/CIRCULATIONAHA.125.074425 PP--US-11862 v1.0

Two charts illustrating the symptom status at the time of AVR conversion based on patient age and biomarker levels. https://doi.org/10.1161/CIRCULATIONAHA.125.074425 PP--US-11862 v1.0

ALT Two charts illustrating the symptom status at the time of AVR conversion based on patient age and biomarker levels. https://doi.org/10.1161/CIRCULATIONAHA.125.074425 PP--US-11862 v1.0

Two charts illustrating symptom status at the time of AVR conversion according to stage of cardiac damage and integrated LV health. PP--US-11862 v1.0

ALT Two charts illustrating symptom status at the time of AVR conversion according to stage of cardiac damage and integrated LV health. PP--US-11862 v1.0

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~40% of asymp. severe AS patients progress to advanced symptoms (acute valve syndrome) & face higher risks of death, stroke, or HF 🏥. The challenge? Predicting who will. I’m teaming up w/ @EdwardsLifesci to encourage early referral to a Heart Valve Team before symptoms escalate.
A white background with maroon text that reads, “Death, Stroke, or HF Hospitalization*.” Below the maroon text is a Kaplan-Meier curve for death, stroke, or HF hospitalization stratified by clinical presentation at the time of AVR. https://www.jacc.org/doi/10.1016/j.jcin.2025.09.029 PP--US-11862 v1.0

ALT A white background with maroon text that reads, “Death, Stroke, or HF Hospitalization*.” Below the maroon text is a Kaplan-Meier curve for death, stroke, or HF hospitalization stratified by clinical presentation at the time of AVR. https://www.jacc.org/doi/10.1016/j.jcin.2025.09.029 PP--US-11862 v1.0

A white background with maroon text that reads, “~40% of patients presented with advanced signs or symptoms at the time of AVR conversion.” A bar line illustrating ~40% lies below the number. https://doi.org/10.1056/NEJMoa2405880 PP--US-11862 v1.0

ALT A white background with maroon text that reads, “~40% of patients presented with advanced signs or symptoms at the time of AVR conversion.” A bar line illustrating ~40% lies below the number. https://doi.org/10.1056/NEJMoa2405880 PP--US-11862 v1.0

A white background with maroon text that reads, “Severe AS patients who developed advanced symptoms had a higher rate of death, stroke or HF hospitalization after AVR.” https://www.jacc.org/doi/10.1016/j.jcin.2025.09.029 PP--US-11862 v1.0

ALT A white background with maroon text that reads, “Severe AS patients who developed advanced symptoms had a higher rate of death, stroke or HF hospitalization after AVR.” https://www.jacc.org/doi/10.1016/j.jcin.2025.09.029 PP--US-11862 v1.0

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86M severe AS & Prior stroke BEV platform & procedure time < 30minutes If risk of stroke is high, what are your technical tips? (Let’s put the EPD discussion to rest for now) ❓should we avoid multiple inflations ❓does the THV platform make a difference @TAVRBot @tavrkapadia @djc795 @AliSahebHusain @almoghairi @HatimLawati @AlhijjiM @fjsawaya @SSamargandy @yaqoub_lina @kalazizimd @AnasNomanMD @drptca @AlkashkariWail @TCT_ME_
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#TAVR poll Patient had SAVR 10 years ago. Echo now shows AVA 0.5 cm2, MG 35 mmHg, Vmax 3.9 m/s, SVI 21 ml/m2, moderate AR. Patient has no symptoms. What next?
23%Moderate. Echo in 6 mo
48%Severe, no symptoms. Wait
29%Severe, go ahead with ViV
104 votes • Final results
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When's the right time to talk with aortic stenosis (AS) patients about treatment options and goals? Patients are ready earlier than HCPs expect. I’m collaborating with @EdwardsLifeSci on ways the Informed Decision Guide can help you start the conversation. ow.ly/KZgE50WUfSx
66%Moderate AS
28%Severe AS before symptoms
4%When symptomatic from AS
2%I feel less certain
47 votes • Final results
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#TAVR poll I like seeing patients with moderate aortic stenosis to explain diagnosis, natural history and surveillance. Also to develop a relationship with patient When do you like to see patients with aortic stenosis?
17%Severe AS, symptoms
35%Severe AS, no symptoms
35%Moderate AS
13%Show results
83 votes • Final results
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#TAVR Bumper Technique This visual shows how this technique works. Without bumper, the leading edge of the THV stent can catch a lip of calcium. With bumper, the 🎈bulges over the leading edge and protects it from catching calcium. Also prevents scraping in aorta.
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#TAVR Bumper Technique This is something I’ve been doing and it makes crossing the aortic valve easy without pre BAV. After final valve assembly in descending aorta, roll contrast into the nose cone to create the bumper. 1. Reduces scraping in aorta. 2. Crosses like butter!
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Treat the valve AND the myocardium when facing severe AS+amyloidosis. Both AVR and tafamidis independently ↓ mortality Dual therapy=best outcomes w/ similar survival to lone AS+AVR. Dual pathology is common (~13%) warranting RCT. tinyurl.com/2zmpht8x Bravo @ThomasTreibel! 👏🏻
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Are we officially changing US nomenclature from #TAVR ➡️ #TAVI
Michael O'Riordan@mpjORIORDAN1 May 2025
FDA Approves TAVI for Asymptomatic Patients With Severe Aortic Stenosis tctmd.com/news/fda-approves-…

FDA Approves TAVI for Asymptomatic Patients With Severe Aortic Stenosis

The agency’s decision for the balloon-expandable Sapien 3 platform is based on groundbreaking results from EARLY TAVR.

tctmd.com
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#TAVR poll Patient with TAVR 11 years ago, S3 26 mm, MG 41 mmHg. CT shows HALT, leaflets no calcification. What is your anticoagulant of choice?
41%Warfarin
30%Eliquis
9%Xarelto
20%Show results
217 votes • Final results
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Is transcarotid TAVR a suitable alternative to SAVR in unsuitable transfemoral access? Transcarotid versus surgical aortic valve replacement for severe AS @MAvvedimento @delportilloJH @sidmengi_dr @pedro_cepas #AHAJournals ahajrnls.org/4iCJPEU
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#TAVR poll Where is the cardiac surgeon during TAVR?
37%Scrubbed in
12%Control room
37%Somewhere in the hospital
14%Office or home
271 votes • Final results
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Replying to @djc795
What would it take for TVT registry to be opened? Both @Edwards_TAVR and @MDT_StructHeart would have to agree? @ACCinTouch @STS_CTsurgery
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