Alex Truesdell @agtruesdell Twitter profile

Last Seen Profiles

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@PPGirls1

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@stw_pdg

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Alex Truesdell

@agtruesdell

2 years

👍Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock💥⚡️: by an all-star multi-disciplinary writing team: …

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Alex Truesdell

@agtruesdell

2 years

Our updated and refined #Shock ⚡️💥protocols (thx to huge multi-disciplinary multi-specialty effort and collaboration-teamwork) are now “live”👍…

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Alex Truesdell

@agtruesdell

4 years

Simple and clear graphic for “donning and doffing” #PPE for OR, Cath/EP Lab, ICU etc staff from the front-lines of #NYC 👏👍...

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Alex Truesdell

@agtruesdell

10 months

👍Coronary Wires, Guide Extenders, Microcatheters etc: Comparisons🤜🤛…

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Alex Truesdell

@agtruesdell

3 years

Terrific Swan-Ganz info-graphic by @a_h_ghoneem and the @CardioNerds team👍…

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Alex Truesdell

@agtruesdell

4 years

@FPWellman Re-upping this one from the AM...

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Alex Truesdell

@agtruesdell

3 years

1/2 STEMI vs. NSTEMI or OMI vs. NOMI: are we routinely missing candidates for emergent revascularization?…

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Alex Truesdell

@agtruesdell

1 year

@JReinerMD 👍Every single successful cardiac arrest resuscitation begins with immediate and effective bystander and EMS CPR and Defibrillation: we only deliver survivors back to their families if we receive survivors from their neighbors and EMS🤝…

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Alex Truesdell

@agtruesdell

1 year

👍Educational Resources for General and Interventional Cardiology Fellows in the Cardiac Catheterization Lab: 2023 update led by @MarwanSaadMD 👉: …

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Alex Truesdell

@agtruesdell

4 years

1/7 Vascular Access for Shock-MCS. Do it the same way every time (“slow is smooth, smooth is fast”). Fluoro Femoral Head. US-guided Micropuncture access, observe micro wire advancement, perform access site angiogram (with wire left in), Preclose (single Perclose)...

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Alex Truesdell

@agtruesdell

1 year

Referral for “stent-ectomy”:: gooseneck snare 🎣 removal of prior stent, calcium 🪨 modification with IVL⚡️, re-stent with IVUS 👁️ guidance 👍…

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Alex Truesdell

@agtruesdell

2 years

1/3 “Intravascular Imaging 👁️ During Percutaneous Coronary Intervention” (by the @ACCinTouch #ACCIC Team): Just Do It, Do It Often (? Always), and Do It Right: Practical Guidance and Programmatic Recommendations🤜🤛: …

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Alex Truesdell

@agtruesdell

6 years

On-call in the hospital today...but I stand in spirit with all my #VetsForGunReform brothers and sisters at today’s nationwide #MarchForOurLives rallies... @Vets4GunReform @AMarch4OurLives

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Alex Truesdell

@agtruesdell

3 years

1/3 👍SCAI SHOCK⚡️Stages Classification Expert Consensus Update 2022💥: endorsed by @SCAI @ACCinTouch @AHAMeetings @ACEPNow @ISHLT @SCCM @ACVCPresident @escardio #STS 👉: …

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Alex Truesdell

@agtruesdell

3 years

Can’t immediately find RCA in the “usual” location? Don’t waste a lot of time and contrast. Stop. Quickly check the next most likely locations: …

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Alex Truesdell

@agtruesdell

3 years

Outstanding Cardiac Critical Care, Shock, and MCS resource by @Abraham_Jacob and Team: 🤜🤛… @SCCM @accpchest @SCAI @HFSA @ACCinTouch

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Alex Truesdell

@agtruesdell

2 years

👍 @escardio #ACVC online “Handbook of Mechanical Circulatory Support”⚡️💥: …

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Alex Truesdell

@agtruesdell

4 years

1/2👇Multi-disciplinary, team-based, protocol-driven, hemodynamic-guided management of #CardiogenicShock in the Field, ER, Cath Lab, OR, and ICU👍... @behnam_tehrani @mpsotka @cmrosner #RameshSingh @ShashankSinhaMD @DrDamluji @_WayneBatchelor @IHVInews

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Alex Truesdell

@agtruesdell

7 months

“1/4 “Hemodynamic Collapse💥🫀⚡️in the Cardiac Cath Lab: Prepare, Prevent, Manage, and Recover…” (Part 1): …

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Alex Truesdell

@agtruesdell

6 years

Bifurcation PCI. How do you “mark” your wires? Me: side-branch wire “in” fold of towel (then flip towel open/closed as necessary to manipulate/load wire), main branch wire “outside” fold. Others?... #radialfirst

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Alex Truesdell

@agtruesdell

2 years

@SCAI #SCAIShock 💥⚡️2022 Classification Update Checklist (great for both Clinical Care and Research)👍: …

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Alex Truesdell

@agtruesdell

2 years

💥Practical Aspects of IVUS-Guided Percutaneous Coronary Intervention👍: … @SCAI @ACCinTouch #ImageAlways

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Alex Truesdell

@agtruesdell

3 months

Let them Eat (or at least Drink)! Guidelines say 4 hours NPO. Many Hospitals (oddly) still say 8 hours NPO. Surveys (unfortunately) show > 13 hours NPO: …

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Alex Truesdell

@agtruesdell

1 year

Myocardial Bridge Monday: …

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Alex Truesdell

@agtruesdell

4 years

Cardiogenic Shock: “known knowns, known unknowns, and unknown unknowns”... @AndrewJSauer @manalalasnag

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Alex Truesdell

@agtruesdell

3 years

I may be the last man not wearing fitted, monogrammed, bespoke scrubs these days😜… #CICUAttending

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Alex Truesdell

@agtruesdell

5 months

👍So very hard to conduct clinical trials in the Cardiogenic🫀Shock💥⚡️population (and demonstrate mortality benefit): so…immense kudos to all the #DanGerShock Investigators 👏. And now…on to #RECOVERIV 🤜🤛: …

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Alex Truesdell

@agtruesdell

4 years

Why intracoronary imaging? STEMI: LAD stent thrombosis within recent 2.5mm DES. Distal reference 3.5mm/proximal reference 4.2mm. Tx with 3.5mm/4.0mm NC POBA (both to RBP). Avoidable with #ImageFirst ...

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Alex Truesdell

@agtruesdell

7 years

Hmmm...notice any problem with the LIMA anastomosis?

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Alex Truesdell

@agtruesdell

4 years

Interventional Cardiology is increasingly a Heart Failure specialty: Fight🥊me😜...

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Alex Truesdell

@agtruesdell

2 years

1/2 👍Back to doing buddy-operator (vs. solo) #CTO101 cases (now with my brand new CTO-CHIP partner @lindsey_cilia ): Case #1 #RadialFirst and #LDTRA blunt cap LAD AWE with Fighter and IVUS-Guided PCI with 3.5mm DES (to 3.7-4.2mm)…

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Alex Truesdell

@agtruesdell

1 year

ACS, Acute Systolic HF, Severe LV Dysftb, Distal LM Trifurcation Dz, Surgical Turn-Down: Impella-assisted, IVUS-guided, DK Culotte POT-Kiss-POT PCI/DES. EDP 40/PASP 70s pre-PCI/Impella: to EDP Teens/PASP 30s post-PCI/Impella (left-in 24h). Now: BB, MRA, ARNI, SGLT2i…

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Alex Truesdell

@agtruesdell

3 years

#CICU Attending is the perfect complement to Interventional Cardiology practice: who’s with me?🤜🤛…

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Alex Truesdell

@agtruesdell

2 years

Focusing on good friends, good times, and good memories (and good glamour photos😜) this #VeteransDay 🇺🇸…

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Alex Truesdell

@agtruesdell

2 years

What hope can there be for a society that neither values nor protects its own children?…

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Alex Truesdell

@agtruesdell

2 years

1/2 Impella removal when no Pre-Close (which is preferred) performed. #RadialFirst iliac balloon🎈occlusion (with wire into SFA). Wire into Ao via Impella rewire port. Replace Impella with 10 Fr sheath and place second wire into Ao: Perclose (post-close) over each wire…

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Alex Truesdell

@agtruesdell

4 years

👇Brand new monthly @ACCinTouch #ACCIC #ACCEC #ACCFIT Case-Based Cath Conference series👍. First session (24 October 10am-Noon EST) featuring: @drmkmittal @PinakShahMD @taraloujones @KateKearney4 @SJcardio @J_M_McCabe @agtruesdell . Registration link/details to follow next week...

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Alex Truesdell

@agtruesdell

1 year

1/4 “Optimal Large-Bore Femoral Access, Indwelling Device Management, and Vascular Closure for Percutaneous Mechanical Circulatory Support” in @AmJCardio : (“soup to nuts”, operator-focused, and “real world”) led by @yadersandoval 👍: …

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Alex Truesdell

@agtruesdell

4 years

👍Invasive Management of AMI-CS by @AHAMeetings team👏: ...

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Alex Truesdell

@agtruesdell

5 years

1/6 Standardized Team-Based Care for Cardiogenic Shock...courtesy of @behnam_tehrani on behalf of our INOVA-SHOCK team (with additional embedded online-only Tables and Figures): ... #waronshock

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Alex Truesdell

@agtruesdell

3 years

@ACCinTouch online Coronary Interventions Handbook👏: …

Coronary Interventions Handbook: An Interventional Council Review - American College of Cardiology

This handbook is intended for all practicing physicians within the field of interventional cardiology, with an emphasis placed upon practical technical and clinical considerations for percutaneous...

www.acc.org

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Alex Truesdell

@agtruesdell

1 year

What does “Purposeful Practice” look like? Once Rota 💎 PCI is complete: rehearse “entrapment” drills with your Cath Lab Team👍: …

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Alex Truesdell

@agtruesdell

2 years

1/2 #SCAI2022 : “How to Integrate SCAI Stages into Cardiogenic Shock Management”⚡️💥… #TeamOfTeams @scai

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Alex Truesdell

@agtruesdell

2 years

Misc Impella tips: #1 Advance O.035in wire to Ao Root via side-arm port (in addition to POCUS) to confirm position, #2 Secure device at same angle of entry as access (and cinch Pre-Close suture and use final Mattress suture [both hidden under dressing here]) to prevent oozing…

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Alex Truesdell

@agtruesdell

4 years

Great fun Zoom-chatting re: “Shock Teams” and “Shock Networks” (and I didn’t have to travel...or even wear pants😜)...

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Alex Truesdell

@agtruesdell

4 years

Be gentle with the #RadialFirst vascular bands to avoid Rumpel-Leede phenomenon (and to preserve Radial artery patency): ...

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Alex Truesdell

@agtruesdell

3 years

IVUS-guided Radial DK-Crush PCI-DES gets the job done👍: ACS, moderate LV dysfunction, surgical turn-down (due to CABG-specific co-morbidities)…

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Alex Truesdell

@agtruesdell

4 years

Love Guide extenders for #RadialFirst distal equipment delivery (when necessary): sometimes advanced with the help of a distal anchor balloon...or over 2-wires (wire/buddy-wire) as here...

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Alex Truesdell

@agtruesdell

5 years

“Normal” MPI, “normal” Echo, “normal” PFTs: “dyspnea” and “fatigue” are angina too... #DyspneaIsAnginaToo

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Alex Truesdell

@agtruesdell

3 years

DK-Crush: “How-To” and “Troubleshooting”👍: by @A_B_Hall and team👉: 🤜🤛… @EuroInterventio

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Alex Truesdell

@agtruesdell

1 year

👍Best Practices for Cardiac Catheterization Laboratory Morbidity and Mortality Conferences: …

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Alex Truesdell

@agtruesdell

3 years

Solution to an age-old #IVUS problem😜: the “Intussusception” technique👍…

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Alex Truesdell

@agtruesdell

2 years

1/4 Guide dissections occur (here with PEA). Don’t inject. Resuscitated (IVF-Epi-NE). Wired vessel: IVUS revealed sub-intimal all-the-way. Parallel Fighter wire re-entered true lumen distal to dissection pre-Cruz (IVUS-confirmed). POBA, IVUS, Stent, IVUS. Lastly…angiography…

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Alex Truesdell

@agtruesdell

6 years

1/3 3rd on-call case of 2019. Inferior STEMI. Left coronary angiography. How would you treat? #radialfirst #accfit

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Alex Truesdell

@agtruesdell

1 year

Radial…Rollercoaster…Ride… #🦇

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Alex Truesdell

@agtruesdell

1 year

👍 @Mechanical Circulatory Support Devices in Acute Myocardial Infarction-Cardiogenic Shock💥⚡️Current Studies and Future Directions” by #JakeJentzer et al🤜🤛: …

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Alex Truesdell

@agtruesdell

4 years

Sometimes...only a 4-way stop-cock will do (EC-Pella: bilateral antegrade perfusion catheters)👍...

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Alex Truesdell

@agtruesdell

11 months

“Should Everyone Be A ‘CHIP’ Operator?”…

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Alex Truesdell

@agtruesdell

7 years

@drdevireddy Agree. Now that (some) dust has settled...here is my "private practice" opinion (attached):

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Alex Truesdell

@agtruesdell

5 years

This year: no “missed” STEMIs. Must know” STEMI equivalents courtesy of: 👍... #ACCFIT #SCAIFIT

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Alex Truesdell

@agtruesdell

3 years

Not the “usual” #RadialFirst Guide position: but got the job done (LM into dominant LCX NSTEMI with patent LIMA-LAD)...

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Alex Truesdell

@agtruesdell

3 years

@PinakShahMD 🤜🤛: I’ve been known to reply “Great! I’ll meet you at the bedside to evaluate the patient and we can decide the best next course of action together”. Sometimes followed by either awkward silence (if caller is not in-house)😜…or appreciation (if caller is in-house)👍…

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Alex Truesdell

@agtruesdell

3 years

Great “Trilogy” by @CartoonSaloon 👍...

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Alex Truesdell

@agtruesdell

3 years

Highlights of a 16-hour Cath Lab day?: 3 separate families’ super kind refrains: “Thank you and your family”, “Bless you”, “Did you have Dinner?” (all energizing and thoughtful comments: but #3 was my personal favorite👍)...

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Alex Truesdell

@agtruesdell

2 years

Not all Shock⚡️is the same: AMI-CS vs. HF-CS by @ShashankSinhaMD and @cmrosner 👍: …

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Alex Truesdell

@agtruesdell

5 years

Cath lab #powermoves 💪. Calcified tortuous RCA referred after failed femoral PCI (inability to advance equipment). #radialfirst completed with microcatheter over workhorse (to exchange for stiff wire), Guidezilla (delivered via distal anchor balloon), and stents via Guidezilla...

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Alex Truesdell

@agtruesdell

6 months

👍Our @ISHVnews Cardiogenic⚡️🫀💥Shock protocols in print (as part of a great review led by @InovaCVfellows 👉: )…

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Alex Truesdell

@agtruesdell

5 years

"High Risk" and/or "Complex" PCI: increasingly the "new normals" in the modern Cath Lab? How do we match our skills to increasing procedural complexity? How do we estimate procedural risks (and better counsel patients)?...

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Alex Truesdell

@agtruesdell

5 years

AMI-CS. Outside xfer. Ostial LAD acute ST. EDP 40, BP 80 on Dopa/Levo. Impella CP. Same-site 6Fr sheath for re-look Cor Angio and IVUS optimization of outside stents (2.75 taken to 3.67 and LM places). Final ipsi run-off angio via 4F Pig, then peel-away removal... #waronshock

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Alex Truesdell

@agtruesdell

2 years

#RotaTripsy : heavily calcified LAD. IVUS wouldn’t cross. Pilot channel with Rota. Then IVUS. Then IVL via Guidezilla for more complete calcium modification. Then IVUS-guided DES…

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Alex Truesdell

@agtruesdell

6 months

“The Intra-aortic Balloon Pump: A Focused Review of Physiology, Transport Logistics, Mechanics, and Complications” (great IABP review for Pre-Hospital, ICU, and Cath Lab Teams👍: …

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Alex Truesdell

@agtruesdell

7 months

Advanced age, ACS presentation, CABG turndown, cardiomyopathy, calcified LM bifurcation dz: Swan and IVUS-guided Impella-assisted (fuuullllly MCS dependent during intervention) DK Culotte POT-kiss💋-POT PCI, IVL⚡️, DES…followed by several-hour-long in-lab Impella wean. Home👍…

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Alex Truesdell

@agtruesdell

3 years

Excellent “Crush” Review and Figures: by @FrnMoroniMD and team👍: …

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Alex Truesdell

@agtruesdell

3 years

Femoral > Radial (it’s just a fad). Who needs US for access (just palpate and stick)? IVUS-OCT is unnecessary (my eyes are better). LAD stents should be 2.5mm or smaller (it’s fine). Lesion prep is a waste of time (underexpansion won’t cause any immediate harm)... #AprilFools

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Alex Truesdell

@agtruesdell

4 years

1/6 #SpokeAndHub #Shock story: 50s Diabetes presents with acute chest discomfort/dyspnea. ECG global ischemia. HR 100s, BP 90s. Cath below at #Spoke Hospital. EF 45% by LV Gram...

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Alex Truesdell

@agtruesdell

3 years

“Intravascular Imaging as a Quality Metric”👍: This Is The Way🤜🤛: …

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Alex Truesdell

@agtruesdell

2 years

👍Management of In-Stent Re-Stenosis (Do-It-Right the first-time or at least Fix-It-Right the next-time)💥: … #ImageFirst

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Alex Truesdell

@agtruesdell

2 years

Grateful Patient reminded me how truly amazing it is (which we often forget) to perform complex coronary interventions: #1 on a beating heart🫀, #2 with a semi-awake patient, #3 via #RadialFirst , #4 as a same-day outpatient procedure👍…

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@agtruesdell

11 months

👍Ultrasound guidance for Vascular Access: ALL Benefit NO Risk: … #JustDoIt

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Alex Truesdell

@agtruesdell

2 years

👍Young patient, refractory lifestyle-limiting angina, loooong RCA #CTO101 : bi- #radialfirst IVUS-guided Guideliner-assisted epicardial X-CART ostial through distal (to crux) RCA PCI/Lithotripsy/DES with @lindsey_cilia 💥…

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Alex Truesdell

@agtruesdell

5 years

What are the biggest changes in your Interventional practice in the past 5 years? For me it’s #1 : adoption of comprehensive hemodynamic assessment in CS and #2 : adoption of routine intracoronary imaging for PCI. You?...

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Alex Truesdell

@agtruesdell

5 years

1/3 Joined AMI-CS LM-LAD PCI case in progress with BP 50s. Stopped in-process PCI. Placed Impella via pre-existing 6 Fr CFA sheath. Stabilized hemodynamics. Performed IVUS-guided #imagefirst LM-LAD PCI (via @jason_wollmuth single-access technique)... #waronshock

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Alex Truesdell

@agtruesdell

3 years

1/4 Why use distal embolic protection (every single time) in SVG-PCI? Here’s why👇. NSTEMI. Culprit subtotal occlusion of SVG via #LDTRA #RadialFirst access…

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Alex Truesdell

@agtruesdell

2 years

👍Recommended educational Cardiac Cath Lab resources for General and Interventional fellows: by @MarwanSaadMD 💥🤜🤛: … #ACCFIT #SCAIFIT

Resources Cath Lab Curriculum MS.AT.7.2022.docx

docs.google.com

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Alex Truesdell

@agtruesdell

11 months

“Standardized Definitions for Cardiogenic Shock ⚡️💥 Research and Mechanical Circulatory Support Devices: Scientific Expert Panel From the Shock Academic Research Consortium”👍: …

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Alex Truesdell

@agtruesdell

2 years

👍Could it be? Are they back🎉? #Langston … @TeleflexCardiol

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Alex Truesdell

@agtruesdell

4 years

1/4 AMI-CS complicated by Cardiac Arrest: rescue ECPR/ECMO and Impella. LM thrombotic sub-total occlusion on angiography...

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Alex Truesdell

@agtruesdell

3 years

Global #CTO101 Crossing Algorithm by a terrific cast of world experts🤜🤛: ...

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Alex Truesdell

@agtruesdell

3 years

Love me some IVUS-guided #Rota #DKCrush LM-LAD-LCX PCI👍... #owleyes

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Alex Truesdell

@agtruesdell

9 months

“Mechanical Circulatory Support in Cardiogenic🫀💥⚡️Shock”: …

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Alex Truesdell

@agtruesdell

4 years

Even if you forget (or opt not) to Pre-Close #Shock Impella: can always Post-Close (via multiple techniques) safely, simply, and effectively (many days later) thanks to the Impella re-wire/re-access port👍...

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Alex Truesdell

@agtruesdell

8 months

1/2 #StentLoss Acute Inferior MI: complicated by incessant VF⚡️and pt movement. Culprit proximal RCA thrombotic occlusion: with severe diffuse underlying dz. Distal-to-ostial IVUS-guided 👁️ PCI/DES: but…final (short) ostial stent mis-deployed. Recaptured over new balloon🎈and…

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@agtruesdell

2 years

1/2 Middle-age woman, acute INF-LAT STEMI, HR 40s, BP 70s: due to SCAD: status-post low-pressure POBA-only to ostial RPLB…

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Alex Truesdell

@agtruesdell

1 year

@ABIMcert Wrong again? Hey @ABIMFoundation @ABIMcert : remember your 2015 “we got it wrong” email? I do. 8 years later you’re still all wrong: over and over and over again. Follow your own advice (below) and #EndMOC …

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Alex Truesdell

@agtruesdell

10 months

Large-Bore Access and Closure (not just for TAVI)👍: @EuroInterventio : “A systematic algorithm for large-bore arterial access closure after TAVI: the TAVI-MultiCLOSE study”: …

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Alex Truesdell

@agtruesdell

3 years

Updated for 2022: (my personal) Impella Access-Management-Closure “Best Practices”: …

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Alex Truesdell

@agtruesdell

6 years

How we do it @inovaheart : team-based, multi-D, hemodynamic-guided management of CV shock: online at , in print at #EuroPCR this week, data submitted to #TCT19 , and even more to be published in 2018/2019... #waronshock #ACCIC #ACCFIT

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@agtruesdell

2 years

@DBarkhuff And…since when did “community policing” become part of SEAL expertise: and…why are local “protect and serve” PDs training to be something they’re not (and should never be)🤷‍♂️?…

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@agtruesdell

1 year

1/3 “Mechanical Circulatory Support for Non-Emergent Complex and High-Risk Percutaneous Coronary Intervention: Who, Why, When, and How?”⚡️💥in @radcliffeCARDIO #USCardiologyReview : …

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