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Thank you very much Dr Sharma 😊 Great learning ! Thanks a lot to your amazing team as well

Trash😊

Thank you so much for your sincere commitment for excellent education and teaching every day including weekends.

Is redo surgery possible and retrival of device possible ?

Sir my mother ppg mpg value is now 30/20 mitral valve ...she already have perimount magna ease 29mm and degenerated after 12 years with single leaflet mobility. Which is the best TMVR system sir which has good track record ..... Sapien 3 ultra or intriped My mother has mitral stenosis, no regurgitation at all.. Balloon valvuloplasty can be done on bioprosthetic value ? Instead of TMVR

Thank you for sharing. The final cranial angio looks like a prox stent edge dissection in the left main.

Thank you

Thank you for your teaching . Your teaching of guidewire design really helps in rewiring the stented artery.

Great case but why would you ever perform a stress test on an 89M w class 3 angina? Waste of time and money.

No

Why wires removed after rota before taking picture ? what if you have a complication( dissection/perf) I find your approach was too reckless

I had watch in morbid fascination, as I've had 3 surgeries so far this, and an soon a 4th. My case is so rare, that I am a case study at Baylor Scott White heart hospital in Dallas TX ( Plano) I wasn't expected to survive, so, they definitely saved my life! Blessings to all who help patients such as myself.

Bridge would be a decent spot to use Agent DCB instead of DES.

Great case. Think 7Fr system would be a superior choice when risk of perf is higher. Can get much better angio w the burr in the coronary. Also more support if you need it for advancing PKP.

Great case and wonderful management. Thank you

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“I won’t comment” is a great comment. Nice case.

Atherectomy in the SI space is not a concern. Do it all the time and have not had any problems with DA or Jet.

Haha. “We’re supposed to talk about but I won’t comment” = lazy fellow, or fellow didn’t prepare.

Great work. One of a kind as usual. Thank you for posting

Thank you

I would have done it differently. Stent the LAD and kissing balloon inflation with NC balloons followed by DEB to diagonal and kBI again with NC in LAD and same DEB in diagonal

Or rota LAD then Diag before performing plasty. Either way is better than the method chosen imo. But excellent case.

Would have been better to rota LAD into Diag first, LAD second, then do CBPTCA and DCB.

Can we do side branch DCB arter main branch stenting because if there is dissection taking pictures could make dissection worse.

Do you think you can achieve the same result without rotablation? Second question is Annu back the side branch rotawire after rotational atherectomy, WhatsApp will happened if there is rota related rupture? İsnt it possible?

Very true: STATE OF ART DEMONSTRATIONS. Thank you so much.

Great work. Outstanding. Thank you so much

Thank you. First time I saw PTAB.

LM-LAD supplied via lima Ptca of ostial lad has big chance of recoil/dissection soon.. Before seeing the final shot, my expectations of the above sentence did happen lima is doing the job, all good. I would habe only stented lima-Lcx

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IVL is good enough alone. IVL would have been more gentle in terms of Brady

Good rota technique. With sub-totaled RCA would have used meds/TVP up front. Liberal use of IC Nipride/Cardene before runs may help? Also would open that RCA in near future.

Aminophyline ideally 5-10m beforehand. Short 5-10s runs. Rarely need TVP

Thank you for sharing this challenging case with us.. I would be happy to see the final result .

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Can we do such case without LV assistant device ?

Great Result! Well done!

Beautifully explained ser,thank u❤

Great case and cath team ! Thank you very much !

Jetstream 2.4/3.4 w filter would do well here too. 2-3 runs blades down, 2 blades up.

Cutting balloon inflation is safe in bifurcation lesion with branch wire?

Great teaching as always. Thank you

Nit.mornek.60..bdolar

what do you think about cerebral embolic protection device use in TAVR

Great job ❤

Thank you very much Excellent teaching case ❤

We have to admit that fighting calcium is not a total win . The proximal stent is still underexpanded. But finally with the current technology even the IVL , this is the best that can be achieved.

Excellent Teaching 🎉 Thank You

Thank you