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] 🫀 Where does ventricular tachycardia hide? A myocardial scar is not just damaged tissue. Within the scar, surviving myocardial fibers can create hidden electrical pathways that sustain VT. This thread explores how 3D mapping reveals these arrhythmogenic circuits. #Cardiology

[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 the limbs: could lipedema affect the cardiovascular system? Lipedema is frequently underdiagnosed and often confused with obesity or lymphedema. This review examines current evidence on potential myocardial, valvular, and vascular abnormalities associated with

[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] 🫀 Lp(a): the next frontier in cardiovascular prevention A genetically determined cardiovascular risk factor, emerging targeted therapies, and one key question: Will lowering Lp(a) translate into fewer cardiovascular events? #Cardiology #Lipidology #CardiovascularRisk

[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] 🫀 Takotsubo syndrome may be more than a “broken heart”. Often associated with emotional or physical stress, Takotsubo syndrome is a complex condition with incompletely understood mechanisms. This review explores the potential role of cardiac sympathetic nerve terminals in the

[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] 🫀 Arrhythmogenic cardiomyopathy is not just an arrhythmia problem. The rhythm disorder may be the first visible sign—but the disease process starts deeper. 1️⃣ Myocardial remodeling 2️⃣ Ventricular arrhythmias 3️⃣ Heart failure progression How are we redefining the management of

[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] 🫀 Atrial fibrillation in older adults: more options, more decisions. A review from the Victorian Heart Institute and Victorian Heart Hospital, @MonashUni, Australia explores evolving procedural strategies for AF management in older patients. Read:

[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] 🫀 How do dying heart cells shape myocardial injury? Myocardial ischemia/reperfusion injury involves complex cell death pathways. A review explores the potential interplay between: 1️⃣ Ferroptosis — iron-dependent oxidative cell death 2️⃣ Pyroptosis — inflammatory cell death 3️⃣

[image] 🫀 When heart surgery meets liver cirrhosis: risk assessment matters. Cirrhosis increases perioperative challenges through: 1️⃣ Coagulopathy & bleeding risk 2️⃣ Renal and immune dysfunction 3️⃣ Cirrhotic cardiomyopathy A review highlights the role of CTP, MELD, VOCAL-Penn and

[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