Cardiovascular Surgery 🫀

[image] 🫀 A successful PCI is more than a good angiographic result. Stent undersizing and malapposition may remain hidden after implantation. 1️⃣ Mechanical defects can drive stent failure 2️⃣ OCT/IVUS improve stent optimization 3️⃣ Imaging-guided PCI enables mechanism-based decisions

[image] 🫀 MINOCA: up to 14% of MIs, not benign. New RCM review from Rome: 5 key etiologies: 1️⃣ Epicardial spasm (~35%) → CCBs; avoid β-blockers 2️⃣ Microvascular spasm (~20–30%) → CCBs, less effective 3️⃣ Plaque rupture (5–40%) → DAPT + statins 4️⃣ SCAD (~4% ACS) → conservative;

[image] 🫀 Mitral regurgitation is not just a valve problem. The same diagnosis can represent different diseases, risks, and treatment pathways. Modern MR management is shifting from “what the valve looks like” to “why the regurgitation occurs.” #Cardiology

[image] 🫀 TAVR vs SAVR: does age matter? US: SAVR<65, TAVR>80; Europe: SAVR<75, TAVR>75; Asia adds bicuspid/rheumatic/cost. ⚠️ <65y: TAVR use surged despite guidelines—higher mortality/pacemaker. 🔗 #CardiacSurgery #Cardiology

[image] ⚡ Surgical AF ablation: from cut‑and‑sew to pulsed‑field. New RCM review from Washington University covers the evolution: ✅ Bipolar RF + cryoablation = gold standard (Cox‑Maze IV) ⚡ PFA: non‑thermal, cardiomyocyte‑selective, rapid lesions ⚡ May enable epicardial ablation on

[image] 🫀 Cardioneuroablation: pacemaker alternative for VVS. 📊 Syncope recurrence: 5.9% post-CNA vs 54% standard care 📊 97% avoid pacemaker in AV block 📊 Complications <1% 💡 For young patients, CNA may beat lifelong pacing. 🔗 #Cardiology

[image] 🫀 When a coronary balloon won’t deflate: what’s next? 1️⃣ Rare but life-threatening PCI complication 2️⃣ Causes: calcification, entrapment & device failure 3️⃣ Algorithm: stabilize → troubleshoot → decompress → retrieve 📄 #Cardiology

[image] 🫀 ATTR-CM clues hide outside the heart. 1️⃣ Carpal tunnel → 10.2% 2️⃣ Lumbar stenosis → 21.3–26.5% 3️⃣ Biceps rupture → 9.4% 4️⃣ Prostate biopsy → 1.4% 💡 Tissue screening during routine procedures catches it 5–10 years earlier. @ClevelandClinic

[image] 🫀 Beyond angiography: seeing the coronary artery wall Coronary OCT is changing how we understand coronary disease. 1️⃣Detect plaque features 2️⃣Guide complex PCI 3️⃣AI may improve image analysis 💡From lumen assessment to vessel biology. #Cardiology #InterventionalCardiology #OCT

[image] 🫀 Alcohol & the heart: no safe level? 🔹 Heavy drinking = ↑ BP, CAD, CM, AF 🔹 J‑curve? likely confounded 🔹 ACM: >80g/day × ≥5 yrs 🔹 Abstinence improves LVEF 💡 No level should be promoted as beneficial. 📄 #Alcohol #Cardiology

[image] 🫀 Heart failure: 64M affected, 5‑yr survival <50%. Time for a new approach. New RCM review from Liverpool & UPenn: ✅ HFrEF: GDMT (ARNI/BB/MRA/SGLT2i) is cornerstone ✅ HFpEF: SGLT2i now evidence‑based; GLP‑1RAs (semaglutide) improve symptoms (STEP‑HFpEF) 🔬 Inflammation is

[image] 🫀 Hypertrophic cardiomyopathy transformed. 💡 Myosin inhibitors target sarcomeric hypercontractility. 🔹 Mavacamten: first-in-class, cuts obstruction & symptoms 🔹 Aficamten: next-gen, shorter half-life, low DDI risk 📄 #Cardiology

[image] 🫀 VT ablation: imaging is key. ✅ ICE → ↓ tamponade & readmission ✅ CMR → gold standard for scar ✅ MDCT → anatomy when CMR unavailable ✅ PET → detects inflammation 💡 Multimodal approach = better outcomes. 📄 #CardiacImaging #Electrophysiology

[image] 🫀 TAVI: from last resort to standard of care. 1️⃣ High-risk: TAVI vs medical therapy 2️⃣ Intermediate: non-inferior to SAVR 3️⃣ Low-risk: superior or non-inferior 4️⃣ Asymptomatic AS: early TAVI works 5️⃣ Next-gen: polymeric valves, SLT, durability #TAVI

[image] 🫀 DCM SCD risk: LVEF is not enough. 5 pillars: 1️⃣ Genetics (LMNA, FLNC, DSP, PLN) 2️⃣ CMR (LGE: 4.75× ↑ risk) 3️⃣ ECG/Holter (NSVT, PVC, TWA) 4️⃣ Biomarkers (NT‑proBNP, hs‑TnT, sST2) 5️⃣ EPS (inducible VT/VF) 💡 Integrate → personalize. 📄 #Cardiology

[image] 🫀 T1 mapping catches iron earlier than T2*. 📊 26.6% had reduced T1 despite normal T2* 📊 T1 & T2* correlated but not interchangeable 📊 Individual T1 trajectories varied widely 💡 T1 mapping complements T2* for monitoring myocardial iron. 📄

[image] 🫀 Is fixing the valve enough? Mitral valve surgery aims to correct regurgitation—but the story may not end there. A review explores how mitral valve repair and replacement differently influence left ventricular hemodynamics, from flow patterns to energy efficiency. #Cardiology

[image] 🫀 AF ablation sedation: no one-size-fits-all. GA, deep, or conscious sedation all used; choice depends on patient, energy (PFA more painful), and center.; Drugs vary; 💡Key: individualize.

[image] 🫀 T1DM cardiovascular risk: distinct, early, high. 1️⃣ Hyperglycemia central driver 2️⃣ "Double diabetes" amplifies risk 3️⃣ Women lose CV protection 4️⃣ Use T1DM-specific tools (ST1RE, NDR) 💡 Early prevention saves lives. 📄 #Cardiology

[image] 🫀 Left ventricular rigid body rotation (LV-RBR): rare but real. 1⃣ LV-RBR in 9% of healthy adults 2⃣ CCW-LV-RBR → dilated systolic AVA 3⃣ CW-LV-RBR → reduced AAPSE 💡 Rotational mechanics affect aortic annular geometry. 📄 #Cardiology

[image] 🫀Intraoperative Atrial fibrillation (AF): a surgical challenge 1️⃣Risk factors: age, AF history, heart disease 2️⃣Triggers: stress, hypoxia, electrolyte imbalance 3️⃣Early recognition → better outcomes 💡Perioperative AF needs attention #Cardiology

[image] 🫀 CRT: one metric isn’t enough. ✅ QRS narrowing ≥20ms ✅ LVESV ↓ ≥15% ✅ LVEF ↑ ≥10% All 3 combined → strong predictor of event‑free survival (AUC 0.835, p=0.006). 💡 Measure electrical + structural + functional response. 📄 #Cardiology

[image] 🫀 CKM syndrome: heart, kidney, and metabolism together. One patient, three specialists—three separate clinics, three disjointed plans. Integrated care works: 💡 Combined clinics 💡 Virtual MDTs 💡 Digital health & wearables 📄read： #Cardiology

[image] 🫀When aortic stenosis becomes urgent: can #TAVR help? Non-elective TAVR in severe aortic stenosis remains challenging 1️⃣Higher mortality reflects patient severity 2️⃣Procedural safety remains acceptable 3️⃣Early intervention may improve outcomes #Cardiology

[image] 🫀 Advanced cardiac magnetic resonance (CMR): the next step in precision diagnosis? 1️⃣ AI & advanced imaging improve CMR 2️⃣ Mapping techniques enhance tissue characterization 3️⃣ Supports early diagnosis & risk stratification 📄 #Cardiology

[image] 🫀 Echo in sports cardiology: beyond screening? 1️⃣ Distinguish athlete’s heart vs disease 2️⃣ Enable personalized exercise assessment 3️⃣ Advance cardiovascular care 💡 Echocardiography guides safer exercise. 📄 #Cardiology

[image] 🫀 Coronary endarterectomy: restoring function in diffuse CAD? 1️⃣ Enables complete revascularization 2️⃣ LVEF improved +16.8% at 6 months 3️⃣ LAD repair showed strong recovery 🔍 Surgical view in the original article. 📄 #Cardiology #CardiacSurgery #CABG