- 95
- 520 092
6 in the A
United States
เข้าร่วมเมื่อ 31 ม.ค. 2021
6-in-the-A is a channel about interventional cardiology and coronary artery disease.
We talk about typical cath lab cases from a typical interventional cardiologist at a typical community hospital. Nothing fancy, just cases you could very well see on your next call.
Cath lab RTs, RNs, midlevels, interventional cardiology fellows, and practicing interventional cardiologists in the community may find the content useful.
Some videos are geared more towards patients.
There may even be a few nuggets to keep my more academically-inclined colleagues entertained!
===
Channel Link: www.youtube.com/@6intheA
===
All contents are for entertainment purposes only. No medical advice is intended or provided. Clinical vignettes do not reflect actual patient scenarios. Any resemblance is purely coincidental. Opinions are my own, and I reserve the right to change my opinion at any time, without notice, and for any reason.
We talk about typical cath lab cases from a typical interventional cardiologist at a typical community hospital. Nothing fancy, just cases you could very well see on your next call.
Cath lab RTs, RNs, midlevels, interventional cardiology fellows, and practicing interventional cardiologists in the community may find the content useful.
Some videos are geared more towards patients.
There may even be a few nuggets to keep my more academically-inclined colleagues entertained!
===
Channel Link: www.youtube.com/@6intheA
===
All contents are for entertainment purposes only. No medical advice is intended or provided. Clinical vignettes do not reflect actual patient scenarios. Any resemblance is purely coincidental. Opinions are my own, and I reserve the right to change my opinion at any time, without notice, and for any reason.
Acute Stent Recoil
We discuss a case of acute stent recoil during ostial RCA PCI, and go over strategies to prevent and deal with stent recoil, including the "pulse post-dilation" technique and double-stenting.
Chao-Wei Hwang, M.D., Ph.D.
Johns Hopkins University School of Medicine
Cardiac Cath Lab, Frederick Health Hospital
Chao-Wei Hwang, M.D., Ph.D.
Johns Hopkins University School of Medicine
Cardiac Cath Lab, Frederick Health Hospital
มุมมอง: 1 689
วีดีโอ
Stenting through Protruding Ostial Stent
มุมมอง 2.6Kหลายเดือนก่อน
We discuss a case of restenosis of an ostial RCA stent that protrudes well out into the aorta. I go over the "Double-Wire Technique" to cannulate the mouth of the protruding stent as well as tips for stenting through the side of a protruding stent. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
LIMA goes where?! Several cases of unusual CABG anatomy
มุมมอง 1.7Kหลายเดือนก่อน
I go over several cases of quite unusual CABG anatomies. Link to LIMA-cardiac vein case: th-cam.com/video/FBXQw3be2p8/w-d-xo.html Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
Cardiogenic Shock from LVOT obstruction post-MI
มุมมอง 2.4K2 หลายเดือนก่อน
We discuss a case of post-MI cardiogenic shock from dynamic left ventricular outflow tract obstruction (LVOTO). We discuss how to manage cardiogenic shock with dynamic LVOTO, and also review other common reasons for post-MI shock. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
Dual Antiplatelet Therapy after PCI in 2024
มุมมอง 2.5K2 หลายเดือนก่อน
My discussion of DAPT after PCI in 2024 at the annual Johns Hopkins Suburban Hospital Interventional Skills Day. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
Nested Bifurcation Stenting of Left Main Trifurcation
มุมมอง 3.3K3 หลายเดือนก่อน
We discuss a case of Left Main Trifurcation PCI that required the use of the "nested bifurcation PCI" technique. This is useful when only 6 French guide catheters are available. We review how nested bifurcation PCI is done and also briefly go over the literature for left main trifurcation stenting. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederi...
STEMI: Could not engage anomalous RCA!
มุมมอง 4.3K3 หลายเดือนก่อน
We discuss a case of anomalous RCA STEMI in which it was impossible to engage the RCA with a guide catheter. We review guide catheters to use with anomalous coronary arteries, discuss wiring with diagnostic catheters, and go over techniques to exchange catheters over coronary wires. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
Tortuous RCA: Re-direction with Sasuke
มุมมอง 2.9K4 หลายเดือนก่อน
We discuss wiring techniques for tortuous coronary arteries, and talk about the use of the Sasuke dual lumen catheter in tortuous vessels as a tool for wire re-direction and potentially for wire re-entry from a dissection plane into true lumen. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
Discordant FFR/iFR/RFR
มุมมอง 1.9K5 หลายเดือนก่อน
We discuss the available evidence for what to do when the FFR result is discordant with the iFR or RFR result. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
DK Crush: Step by step
มุมมอง 8K6 หลายเดือนก่อน
We go over how to perform the DK Crush stenting technique (double kissing crush) step by step for non-provisional bifurcation PCI in a LAD/Diagonal bifurcation case. Other bifurcation videos you might be interested in: TAP stenting (LAD/Diagonal bifurcation): th-cam.com/video/YC2WlbKAR4g/w-d-xo.html TAP stenting (LCX/OM bifurcation): th-cam.com/video/TZUb6IRRwvA/w-d-xo.html Culotte stenting: th...
PCI of Septal Perforator in Isolated Septal STEMI
มุมมอง 3.4K7 หลายเดือนก่อน
We discuss septal branch PCI in an unusual case of an isolated septal STEMI without LAD involvement. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
How to size kissing balloons and POT balloons
มุมมอง 4.6K8 หลายเดือนก่อน
We discuss Finet's Law (2/3 rule), Murray's Law, and Mitsudo's Proposal for how to size kissing balloons and POT balloons in bifurcation PCI. We also give specific example for how to use these rules in PCI cases. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
Wellens T waves & de Winter T waves
มุมมอง 4.3K8 หลายเดือนก่อน
We review two ominous T wave abnormalities that are important to recognize early: the de Winter T waves (STEMI-equivalent indicating acute LAD occlusion) and the better known Wellens T waves (suggesting severe LAD stenosis). We discussed diagnostic criteria and management. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
STEMI from SCAD
มุมมอง 3.2K9 หลายเดือนก่อน
We discuss a case of SCAD (spontaneous coronary artery dissection) that resulted in a STEMI. We go over PCI techniques for SCAD, which are often opposite for what we normally do for PCI. We also review the mechanism for SCAD formation as well as strategies for medical management and SCAD prevention. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Freder...
How to Switch P2Y12 Inhibitors
มุมมอง 1.6K9 หลายเดือนก่อน
We discuss expert recommendations on how to switch between oral P2Y12 inhibitors (clopidogrel, ticagrelor, prasugrel) as well as the intravenous P2Y12 inhibitor cangrelor. Chao-Wei Hwang, M.D., Ph.D. Johns Hopkins University School of Medicine Cardiac Cath Lab, Frederick Health Hospital
LBBB + MI: Sgarbossa and Modified Sgarbossa Criteria
มุมมอง 5Kปีที่แล้ว
LBBB MI: Sgarbossa and Modified Sgarbossa Criteria
PCI in the elderly: Should Great Grandma go to the cath lab?
มุมมอง 2.6Kปีที่แล้ว
PCI in the elderly: Should Great Grandma go to the cath lab?
Rough STEMI then balloon could not deflate!
มุมมอง 5Kปีที่แล้ว
Rough STEMI then balloon could not deflate!
Erratum: In "Step 9" / Slide 20 / 14:40 mark, re-wiring the side branch again should be through 2 stent layers, not 3.
One of our astute viewers thought that the IVUS image actually showed that the IVUS catheter was in false lumen, and that the true lumen was to the right of the dissection flap. I thought we were true lumen throughout, but I must admit that sometimes I still have trouble telling things apart. Color doppler might have helped. In this case, we principally wanted to make sure that we ended in true lumen. This was clear in the full IVUS run (which I don't show). Fortunately for us, there are no branches to worry about in the LIMA, so it's less critical if part of the stent was in false lumen as long as the ends are in true lumen.... What I am sure of is this: The more I do this, the more I realize how much I still have yet to learn.