In a life blessed w/many joys & proud moments, this might be the proudest moment yet for
@SunitaNathanMD
& myself. Our daughter just graduated from UC Lab School & starts undergrad
@UChicago
this fall! Much gratitude to all her teachers & mentors. CONGRATS Anokha! You did it!!
60yo w/
#COVID19
PNA x 2wks, now saddle PE, pulm infarcts + hemorrhage. >1.5 ft of clot extracted w
@InariMedical
T24: Near-normalization of PA-gram & sats.
#COVID
clots not just real, but really extensive/organized. Lots we don’t know yet. Pix used w/pt permission.
#cardiotwitter
Did we just discover a novel cardiac structure? It’s currently being called “flippy cardiac structure NOS” (although “pretty distracting during a 3hr roto case” also works nicely). Any ideas what it actually is?
#CardioTwitter
[posted w/permission]
Great line from a new patient: “Hi doc. I’m homozygous for a CYP2C19 reduced function allele so you should probably switch me to Prasugrel before PCI. I work in pharmacogenomics BTW but my physician daughter doesn’t believe me. Totally up to you though...” 🤣
#CardioTwitter
Pre
#TAVR
grenadoplasty (thx to a calcium spike on this bicuspid AoV, CT pix👇🏽). 22x40 Nucleus ruptured along full length of balloon - took some effort to pull it out of the eSheath. Not big fans of loud popping noises in the
#UChicagoCathLab
.
#CardioTwitter
#MedTwitter
So I bid a fond farewell to my friend & colleague of 12 yrs,
@HNayakEP
who leaves
@UChicagoMed
today to lead as EP Director at UT San Antonio. Congrats, good luck & thank you for everything, Hemal! You always have a place to stay in Chicago, brother!
#CardioTwitter
#MedTwitter
First Chicago implant of
@Abiomed
#Impella
RP Flex: Severe RV shock in pt w/prior LVAD - remarkably flexible (as advertised), supportive (3.1-3.3L/min at P6) & conducive to rapid deployment with venous Perclose x 2 before & figure 8 stitch after.
#CardioTwitter
#UChicagoCathLab
Category:
#RadialFirst
challenges you only see after 5P on Fridays. Resistant 360 subclavian loop+bovine arch+severe angle at innominate-aortic jxn. 5Fr RIM+300cm Wholey-> 6Fr Ikari 3.5L guide-> 0.035in Amplatz extra-stiff wire-> case completed with wire in guide/through Copilot.
Today I did something I’ve somehow (?) never done before: Attend a
#Cardiology
meeting w/the “original Dr. Nathan”. V few cardiologists who’ve been at it for nearly 50yrs & 3 continents! Was truly an honor to talk shop with my first, best & most impactful
#mentor
.
#CardioTwitter
Brought home a heart model for my daughter’s middle school CV module. Very first question: “If I stuck my finger right here in an *actual* patient, what would happen?” I’m unclear at this point whether she’s leaning towards
#InterventionalCardiology
, CT surgery or Pathology. 🙄
Last few days hanging w/these 2 fine IC docs: Drs.Ali Alsaad & Abdulrahman Dia. Great job, thank you & good luck! Abdul: C U around at AngioClub. Ali: Enjoy your July fellows.😉 Remember: Nobody will ever take u seriously unless you’re on Twitter.
#UChicagoCathLab
#CardioTwitter
Best exchange fr
#CICU
rounds this AM:
Intern 1: She has pulmonary edema, cardiomegaly & some type of sternotomy hardware - although there’s no record of CABG.
Intern 2: Uhhh… that’s a bra.
Intern 1: Well, that wasn’t in the final radiology read, so…
Well, “good” news: the
#Covid
-related STEMI drought is officially over: It rained PUI STEMIs, shock & OHCA all wknd. Kept w/house rule of showering upon entering the home but between CCU rounds & cases, I’ve never taken so many showers within a 72 hr period (8 to be exact.) 😕
Here’s an unusual trifecta: Young
#COVID19
+ pt with massive AW STEMI sent for rescue PCI after failed lytics w/transfer delays 2/2 protest lines: tPA+Enox+ASA (OSH) then UFH+ticagrelor+cangrelor+ Angiojet+IVUS+110mmDES. Surprised & grateful for no shock/bleeding
#RadialFirst
This week,
@jihohan2
pioneered a new method for antegrade
#CTO
crossing at the
@UCCardsFellows
#UChicagoCathLab
workshop. We’re open to suggestions for the name of this novel technique. Was thinking SCARE (Subintimal CAtheter Rollercoaster & Entry) but I’m sure there’s better.🤔
1 yr ago I posted this crash EC-Pella case in a young peripartum who went to HVAD+temp Centrimag RVAD support. Yesterday, a happy ending to the story: LVAD decommissioning in the
#UChicagoCathLab
w IVUS-guided 14mm AVP2 occlusion of the cannula. EF 55% & a win in the
#WarOnShock
Don’t usually post personal stuff but *super-proud* of my 14yo daughter who planned/executed a restaurant-worthy 3-course meal from SCRATCH!
#celebritychef
seems like a reasonable backup career to
#interventionalcardiology
but maybe that’s the white chocolate mousse talking?! 😃
Apparently
#IRad
docs are regularly sentenced to clinic time, just like the rest of us working-class shmoes?! What a time to be alive.... 🤣😂🤣
#MedTwitter
#Cardiotwitter
Got this in the mail today - we’re *finally* one step closer to
#Diwali
becoming a “real” US holiday. If Sam Adams creates a limited edition beer, I light up a palm tree & we embrace some oddly specific food traditions, this holiday could become legit overnight. Can’t wait… 😂🤣
It was a great pleasure to learn from
@JamesCFangMD
today, our 2023 Dr. Jafar Al Sadir Cardiology Grand Rounds lecturer
@UChicagoMed
. Also wonderful to see legendary clinician & Prof. Emeritus, Dr. Al Sadir! Thank you both for visiting us!
#MedEd
#MedTwitter
-
#CardioTwitter
I got this unsolicited
#TAVR
testimonial from a satisfied customer - made my day. Based on this endorsement alone, I see *at least* 4 more TAVR indications in the near future (I believe that’s how the
@US_FDA
process works, right?) 🤣
#cardiotwitter
Saw one of my favorite patients in clinic who brought this image with him (posted w/permission). He went into a surgical pulmonary embolectomy 17 yrs ago w/near-systemic PA pressures. Today: NYHA1 still, w/near-NL hemodynamics & RV fxn. Just amazing.
#CardioTwitter
#MedTwitter
I could definitely get used to a life of cake, gifts & surprise ninja decorations. 🤣 Huge thanks to the
#UChicagoCathLab
, my partners, fellows & esp. the amazing JiF who has mad baking skills (but sadly, has no Twitter). You guys are awesome!
Each time we get a thrombosed MVR (29 OnX) we scramble to recall lytic dosing. Regimen we just used (summarized fr recent pubs-thx
@SajniPatel2
!): 25mg tPA over 6hrs via PA catheter (no bolus), re-dosed q24hrs x2 (max 5x)=75 mg over 3d w TTEs q24hr. See pix below.
#CardioTwitter
Haha - I love it!! So awesome to be turned into a comic character by the talented
@shirlywhirlmd
! Come to think of it, the Lucas has definitely seen some action this past week. 🤔
#UChicagoCathLab
#CardioTwitter
#RadialFirst
in a 39yo w/MI & found *very* resistant clot; finally resolved w/PTCA, “bottle-brushing”, IC/IV eptifibatide, many thrombectomy passes & 2 DES. Love shiny new Cath Lab toys but it’s still pretty satisfying when “old school” gear & techniques work.
#cardiotwitter
So happy to say
#GoodBye2020
. (The sentiment was captured in sugar cookie by my daughter.) Here’s to a better, happier & more sane 2021! 🥂 Looking forward to seeing you guys outside of a Zoom call, in the near future!!
How’s this for a clean break? An ad hoc
@ShockwaveIVL
case emerged fr/a minimally calcified lesion which turned out to be balloon undilatable (2.75 mm NC at >24 ATM). Beautiful IVUS Chroma images shows where the arc of Ca+ split. No mo’ Rota-regret.
#CardioTwitter
#RadialFirst
5 ECMO cases in 5d in
#UChicagoCathLab
(4 in 48hrs) 2 for confirmed
#COVID19
ARDS + many PERT calls for Covid pts. Total # of Covid cases dropping in US but deaths rising & def feels like spike in critically ill inpts again. Is everyone else seeing this also?
#cardiotwitter
I spotted this guy today at 57th & Payne, apparently heading towards
@UChicagoMed
ER. I hope he’s familiar with our masking & visitor policies. Is “coyotes in the vicinity” a legit exclusion for D2B time? 🤔
#chicagowildlife
#ForefrontOfCoyotes
Big thanks to
@SVRaoMD
for visiting
@UChicagoMed
, meeting w the
@UCCardsFellows
and delivering an exceptional GR on bleeding, transfusions &
#RadialFirst
. Always a pleasure to C U & totally not weird that it looks like we coordinated outfits (right down to watches & shoes). 😂
Hanging out in the rainy woods of Michigan this
#Thanksgiving2021
& counting my (many) blessings. Grateful for my wonderful family, girls,
@SunitaNathanMD
, amazing
@UCCardsFellows
(many of whom, sadly, have no Twitter 😕) & my friends across the world. Thank you all!
#gratitude
Looking for qualified
#IC
applicants to join us as full-time
@UChicagoMed
/
@uchicagohvc
faculty at Asst. Prof. level.
#UChicagoCathLab
is busy, diverse, collegial and above all, entertaining (not to mention the fact that the hospital recently invested in a boba tea machine 😂)
#CardioTwitter
poll time: Large caliber, heavily calcified RCA with 360 degree turn proximally and eccentric calcium nodules throughout the mid-segment in a patient w/lifestyle-limiting angina despite antianginals. What’s your technical approach? Poll below; pls vote & RT.
Night walk along the best beach in the continental 🇺🇸: Clearwater Beach, FL on a clear night this week w Leo visible behind the moon. (Also: Night Mode on iPhone 13Pro legit kicks a**). Best. Vaca. Ever.
I walked into this: It’s like a battle scene from
#GameOfThrones
on my desk but with gummy actors. All because I pointed out to Janet Friant (who is sadly Twitterpenic) & the
#UChicagoCathLab
that Haribo is superior to Albanese IMHO. Her response really sends a message…🙄
It was a true honor to present
@DukeHeartCenter
Grand Rounds this week on MCS in HR-PCI & CS. Many thanks to
@manesh_patelMD
& Dr. Rajiv Swamy for the warm welcome. So good to see many old friends & make new ones. Best of all, great to exchange ideas live & to learn. Thank you!
Photoshopping an old airline reservation: 5 minutes. Sending out a couple of bogus texts: Standard data rates. Actually pulling one over on your teenager on April Fools Day: Priceless.
#SCAI2022
meeting starts w/a pic
@MyJSCAI
station & the *best* faculty tag ever. Ribbons articulating (let’s be honest) what we’re ALL THINKING is a stroke of genius from
@SCAI
’s Chris Trimmer. So good to see old friends & ones who previously only existed on Zoom.
#CardioTwitter
This is totally insane. I may have just reached my breakpoint with gas vehicles.
@elonmusk
may (finally) be getting my money soon. What’s the highest you’ve paid lately for gas across the country (incl HI) and outside of the US? Poll below. 🫤
I’m thrilled that my work is finally being recognized outside of
#InterventionalCardiology
. The organizers obviously understand that
#IVUS
is THE missing piece in the growing field of CardioObstetrics. Looking for speakers & panelists for the fantastic session I’m planning.
Fitting send off for the 2022
@UChicagoMed
IC fellows & welcome to new 2023 IC fellows: Drs. Rishi Pandya & Abdulrahman Abutaleb (arrows; we try to maintain a minimum 50% Abdul ratio). Also the first time we’ve gotten the amazing
#UChicagoCathLab
Crew out in 2.5 years! Thx guys!
HVAD outflow cannula kink w/35mmHg gradient & low flows. IVUS of prox/ostial cannula. Stented w/11x59mm VBX, 5mm into aorta. Deployed w/epi+CPR (⬇️); good result/hemos. Now that HM3 common & cannula ≥14mm, what stent are you using?
#CardioTwitter
#MedTwitter
#UChicagoCathLab
Another good option in the absence of Langston pigtail catheters, for simultaneous Ao/LV measurement:
#RadialFirst
, 6Fr JR4 guide in Ao, 4Fr/135cm Trailblazer in LV. Clean hemos (below) despite 0.018in lumen & approx $500 less than using FFR/iFR wire.
Big win for NYU Langone Health. Good luck in your new role
@SVRaoMD
! Remember: The treatment of seasonal affective disorder in folks moving up north usually begins with upgrading your winter jacket.
#CardioTwitter
Thrilled to announce that Dr. Sunil Rao joins us today at NYU Langone Health as our new Director of Interventional Cardiology. Learn more about Dr. Rao ⤵️
Thank you to all who made
@SCAI
FIRST
#Chicago
a success! 6 fantastic FIT presentations (title slides👇🏽) & discussion by an expert panel of colleagues. Special thanks to
@AdhirShroff
@spiritus_bah
& to our commercial supporters. Looking forward to the next one!
#CardioTwitter
So a funny thing happened to
@DTPham_CVSurg
& I on way back fr
@CSIcongress
. Our plane...uhhh...sprung a fuel leak. U-turn over the UK, emergency landing in Manchester, fire trucks on tarmac, 5hr road trip to London (never believe GoogleMaps), spent the night & flew home today.
Sneezed/coughed a couple of times yesterday (for 1st time in like 2yrs). Hmm… Scraped my cribriform plate. Waited 15 min. *Phew* Scheduled PCR to confirm. Tried to decide which N95 goes best with a suit. How’s the “New Normal 2.0” going for you guys? 😑
#CovidLife
Happy Thanksgiving! So grateful for my wonderful (extended) family: good friends &
@UChicagoMed
colleagues, the
#UChicagoCathLab
,
@UCCardsFellows
,
@MyJSCAI
fam, mentors & collaborators around the world. “Under the skies, under the heavens there is but one family.” - Bruce Lee
I’m *truly* enjoying the beauty and wonder of first snow in Chicago… as I sit perfectly motionless, in complete gridlock on the way back to the Cath Lab from outreach clinic.😕
Am I the only one who finds our E-verification, mildly stressful & super-irritating? How am I failing like 30% of these?! What if (hypothetically) I’m from somewhere with no crosswalks or yellow cabs? How about some quizzes featuring auto rickshaws or colorful dance sequences?
Have you ever asked yourself, “Why EXACTLY will I be scrubbed at 2AM this call weekend?” Fortunately the
#UChicagoCathLab
staff has found a way to make holiday call uncertainty, interesting once again. My bets are on
#3
down or
#3
across. Next holiday maybe we sell squares? 😂
My 5yo nephew detailing his career plans at his kindergarten graduation: “Cardiologist+race car driver” (for all the right reasons 😆). Best graduation speech ever. Here’s to all future
#CardiologyFellows
-
#ACCFIT
class of 2045 representin!
#futuredoctor
Perfect ending to a perfect
#SCAI2024
. Congratulations to
@georgedangas
@SCAI
leadership, & entire conference team for a really well organized/executed meeting. See you at
#SCAI2025
but before then, see you at
#SCAISHOCK
Oct 17-19, 2024, in Washington DC!
On behalf of
@UChicagoMed
/
@uchicagohvc
, thank you to friend &
@MyJSCAI
co-editor,
@AGoldsweig
who left
#TCT2023
last nite on a red eye & stepped off a plane at ORD this AM to give Cardiology GR: Scholar+road-warrior. Bonus points awarded for an outstanding tie (which I want now)
I was *so excited* to get email from someone other than Ruby and even more excited to finally be asked to be Chair of the World! Imagine my disappointment when I read past the second line... Also, I don’t go by “Linda” anymore. 😕
@Linda_Lee_MD