Alex Truesdell
@agtruesdell.bsky.social
Interventional Cardiologist. Combat Veteran AF-IZ-XK. Father. #CardiacCriticalCare #CardiogenicShock #CTO101 #ImageFirst #RadialFirst
2/2 2/2 And…single-access Swan 🦢 monitored Impella-assisted IVUS 👁️ guided LM-LAD-LCX DK Culotte Kiss 💋 POT 🍯 Kiss 💋 POT 🍯 PCI/DES: with device removal post-procedure (via single pre-close Perclose)…
January 12, 2025 at 12:56 PM
2/2 2/2 And…single-access Swan 🦢 monitored Impella-assisted IVUS 👁️ guided LM-LAD-LCX DK Culotte Kiss 💋 POT 🍯 Kiss 💋 POT 🍯 PCI/DES: with device removal post-procedure (via single pre-close Perclose)…
1/2 Dec-Jan #LeftMain 🫀Chronicles continue. Advanced age. Cardiac arrest. NSTEMI. Moderate LV dysfunction. Severe LM bifurcation dz. Outside Hospital xfer post-recovery for PCI…
January 12, 2025 at 12:56 PM
1/2 Dec-Jan #LeftMain 🫀Chronicles continue. Advanced age. Cardiac arrest. NSTEMI. Moderate LV dysfunction. Severe LM bifurcation dz. Outside Hospital xfer post-recovery for PCI…
3/3 3/3 👍 Relevant (and excellent) editorial by @jaygirimd : (excerpt below): 🔗 www.ahajournals.org/doi/10.1161/...
January 12, 2025 at 12:55 PM
3/3 3/3 👍 Relevant (and excellent) editorial by @jaygirimd : (excerpt below): 🔗 www.ahajournals.org/doi/10.1161/...
2/3 2/3 Impella-assisted IVUS 👁️ guided LM-LAD-LCX DK Culotte (POT 🍯 Kiss 💋 POT 🍯) PCI/Shockwave ⚡️IVL/DES and AWE (Sion Black) LAD CTO PCI/DES (2.7-3.7mm LAD, 3.1-3.7mm LCX, 4.0-4.5mm LM) 🔗 pubmed.ncbi.nlm.nih.gov/32338608/…
January 12, 2025 at 12:55 PM
2/3 2/3 Impella-assisted IVUS 👁️ guided LM-LAD-LCX DK Culotte (POT 🍯 Kiss 💋 POT 🍯) PCI/Shockwave ⚡️IVL/DES and AWE (Sion Black) LAD CTO PCI/DES (2.7-3.7mm LAD, 3.1-3.7mm LCX, 4.0-4.5mm LM) 🔗 pubmed.ncbi.nlm.nih.gov/32338608/…
1/3 Advanced age. Near-normal EF. Refractory angina. Calcified 🪨 LM proximal through distal bifurcation (Medina 1,1,1) dz and calcified 🪨short LAD CTO (images below): referred for PCI after Heart 🫀Team evaluation…
January 12, 2025 at 12:55 PM
1/3 Advanced age. Near-normal EF. Refractory angina. Calcified 🪨 LM proximal through distal bifurcation (Medina 1,1,1) dz and calcified 🪨short LAD CTO (images below): referred for PCI after Heart 🫀Team evaluation…
2/2 Then true-lumen from Ostium into RV Marginal with Mongo wire. Then 2nd Mongo wire true lumen to RPLB via Sasuke dual-lumen microcatheter. All 3 wires visible below. Final switch to Marvel workhorse wire for IVUS 👁️ guided PCI/DES (ostium to crux)👍…
January 3, 2025 at 11:24 PM
2/2 Then true-lumen from Ostium into RV Marginal with Mongo wire. Then 2nd Mongo wire true lumen to RPLB via Sasuke dual-lumen microcatheter. All 3 wires visible below. Final switch to Marvel workhorse wire for IVUS 👁️ guided PCI/DES (ostium to crux)👍…
1/2 Ostial-thru-mid RCA calcified 🪨CTO: referred to our Team after prior failed attempts. Started Retro surfing 🏄♂️ but no suitable Septals (primarily telephone 📞 cord epicardial collaterals). Pivoted to AWE. Got subintimal purchase with P200👍…
January 3, 2025 at 11:24 PM
1/2 Ostial-thru-mid RCA calcified 🪨CTO: referred to our Team after prior failed attempts. Started Retro surfing 🏄♂️ but no suitable Septals (primarily telephone 📞 cord epicardial collaterals). Pivoted to AWE. Got subintimal purchase with P200👍…
3/3 3/3 And…very very much looking forward in 2025 (and beyond) to more, smaller, stronger, better PVAD options (for both HRPCI and CS)👍…
January 3, 2025 at 12:33 PM
3/3 3/3 And…very very much looking forward in 2025 (and beyond) to more, smaller, stronger, better PVAD options (for both HRPCI and CS)👍…
2/3 2/3 Follow-on PVAD-assisted (with some facilitating iliac POBA) and IVUS 👁️ guided LM-LAD-LCX DK Culotte PCI/DES (3.7-4.1mm in LAD/LCX and 4.5-5.0mm in LM). Impella out and Protamine at end👍: 🔗 pubmed.ncbi.nlm.nih.gov/32338608/ and pubmed.ncbi.nlm.nih.gov/39445416/…
January 3, 2025 at 12:33 PM
2/3 2/3 Follow-on PVAD-assisted (with some facilitating iliac POBA) and IVUS 👁️ guided LM-LAD-LCX DK Culotte PCI/DES (3.7-4.1mm in LAD/LCX and 4.5-5.0mm in LM). Impella out and Protamine at end👍: 🔗 pubmed.ncbi.nlm.nih.gov/32338608/ and pubmed.ncbi.nlm.nih.gov/39445416/…
1/3 Welcome to 2025🥳. NSTEMI. Acute Systolic Heart Failure. Moderate LV Dysfunction. Diagnostic angiography below (Severe LM bifurcation Dz and RCA CTO: with IABP insertion and Hospital xfer)…
January 3, 2025 at 12:33 PM
1/3 Welcome to 2025🥳. NSTEMI. Acute Systolic Heart Failure. Moderate LV Dysfunction. Diagnostic angiography below (Severe LM bifurcation Dz and RCA CTO: with IABP insertion and Hospital xfer)…
3/3 Percutaneous MCS for High-Risk PCI: Why? Who? When?…
December 29, 2024 at 2:38 PM
3/3 Percutaneous MCS for High-Risk PCI: Why? Who? When?…
2/3 Follow-on PVAD-assisted and IVUS 👁️ guided LM-LAD-LCX DK Culotte PCI/DES (3.7-4.1mm in LAD/LCX and 5.0-6.0mm in LM). And…immediate post-PCI “can I go home tonight?”😂… #PercCABG
December 29, 2024 at 2:38 PM
2/3 Follow-on PVAD-assisted and IVUS 👁️ guided LM-LAD-LCX DK Culotte PCI/DES (3.7-4.1mm in LAD/LCX and 5.0-6.0mm in LM). And…immediate post-PCI “can I go home tonight?”😂… #PercCABG
1/3 Advanced age. Severe LV Dysfunction. Acute Systolic Heart Failure. NSTEMI. Diagnostic angiography below (Severe LM bifurcation and multi-vessel CAD: with IABP insertion and Hospital xfer)…
December 29, 2024 at 2:38 PM
1/3 Advanced age. Severe LV Dysfunction. Acute Systolic Heart Failure. NSTEMI. Diagnostic angiography below (Severe LM bifurcation and multi-vessel CAD: with IABP insertion and Hospital xfer)…
👍I’d say there is (at least) equipoise here (with IVI-guidance/optimization and dz not involving the trifurcation) re: #PCIvsCABG (LM Megatron DES: 5.3 mm distal to 6.0 mm ostial [with already-in-place IABP: removed post-PCI]): 🔗 www.jacc.org/doi/10.1016/...
December 28, 2024 at 7:54 PM
👍I’d say there is (at least) equipoise here (with IVI-guidance/optimization and dz not involving the trifurcation) re: #PCIvsCABG (LM Megatron DES: 5.3 mm distal to 6.0 mm ostial [with already-in-place IABP: removed post-PCI]): 🔗 www.jacc.org/doi/10.1016/...
Happy Holidays 🕎🎄Friends…
December 26, 2024 at 1:29 AM
Happy Holidays 🕎🎄Friends…
👍#CiCU Holiday Cheer: IYKYK😜…
December 18, 2024 at 1:02 PM
👍#CiCU Holiday Cheer: IYKYK😜…
2/2 Nice addition to prior “Management of Percutaneous Coronary Intervention Complications“💥: both mandatory (IMO) at-least-annual reading (and mental-physical rehearsal as an individual and Team): 🔗 pubmed.ncbi.nlm.nih.gov/32527193/…
December 14, 2024 at 1:38 PM
2/2 Nice addition to prior “Management of Percutaneous Coronary Intervention Complications“💥: both mandatory (IMO) at-least-annual reading (and mental-physical rehearsal as an individual and Team): 🔗 pubmed.ncbi.nlm.nih.gov/32527193/…
1/2 👍”Never walk into a Cath Lab you (and your patient) can’t walk out of”: Clinical expert consensus document on bailout algorithms for complications 💥 in percutaneous coronary intervention: 🔗 pubmed.ncbi.nlm.nih.gov/39627466/…
December 14, 2024 at 1:38 PM
1/2 👍”Never walk into a Cath Lab you (and your patient) can’t walk out of”: Clinical expert consensus document on bailout algorithms for complications 💥 in percutaneous coronary intervention: 🔗 pubmed.ncbi.nlm.nih.gov/39627466/…
👍Pretty amazing history (of grit and innovation) in our field 🫀here…
December 14, 2024 at 1:11 PM
👍Pretty amazing history (of grit and innovation) in our field 🫀here…
Great to participate (even if remotely) in #ICI2024👍: icimed.org…
December 9, 2024 at 12:22 PM
Great to participate (even if remotely) in #ICI2024👍: icimed.org…
ACS. Severe LV Dysftn. Acute HF. Mod-Sev AS. Critical LM dz (and RCA CTO). Prohibitive PAD for MCS. So: “rapid-fire” POBA with Epi/NorEpi gtt (with 60-sec loss of pulsatility) followed quickly by (less eventful) PCI/DES and final IVUS 👁️ optimization: 🔗 pubmed.ncbi.nlm.nih.gov/36423996/…
December 9, 2024 at 12:21 PM
ACS. Severe LV Dysftn. Acute HF. Mod-Sev AS. Critical LM dz (and RCA CTO). Prohibitive PAD for MCS. So: “rapid-fire” POBA with Epi/NorEpi gtt (with 60-sec loss of pulsatility) followed quickly by (less eventful) PCI/DES and final IVUS 👁️ optimization: 🔗 pubmed.ncbi.nlm.nih.gov/36423996/…
Mixed Cardiogenic-Vasodilatory ⚡️🫀💥 Shock: Current Insights and Future Directions: www.sciencedirect.com/science/arti...
December 5, 2024 at 6:48 PM
Mixed Cardiogenic-Vasodilatory ⚡️🫀💥 Shock: Current Insights and Future Directions: www.sciencedirect.com/science/arti...
Holiday 🕎🎄#CTOPCI planning meeting 🎸🥁🎷…
December 5, 2024 at 3:33 AM
Holiday 🕎🎄#CTOPCI planning meeting 🎸🥁🎷…
Who uses Protamine post-PCI in the Cath Lab 🤷♂️? Currently using for all CTOs (after coronary gear removal) and all elective Impella high-risk PCI (after device removal). What do others do? 🔗 pubmed.ncbi.nlm.nih.gov/37172213/%E2...
December 2, 2024 at 1:40 PM
Who uses Protamine post-PCI in the Cath Lab 🤷♂️? Currently using for all CTOs (after coronary gear removal) and all elective Impella high-risk PCI (after device removal). What do others do? 🔗 pubmed.ncbi.nlm.nih.gov/37172213/%E2...
👍 Happy 🦃🇺🇸🍁 Thanksgiving
2024: founders.archives.gov/documents/Wa...
2024: founders.archives.gov/documents/Wa...
November 28, 2024 at 1:42 PM
👍 Happy 🦃🇺🇸🍁 Thanksgiving
2024: founders.archives.gov/documents/Wa...
2024: founders.archives.gov/documents/Wa...