Dr Irfan Yaqoob Bhat, Sr. Interventional Cardiologist.

02/09/2023

It has been one and half month since I have joined Kailash Healthcare Dehradun as Senior Consultant and head Cardiolgy. This is the first ever case and my first case in this Hospital.
65 years old male presented with not able to talk called technically as Motor Apasia (a type of a brain stroke) with no weakness. MRA showing 80% stenosis in right ICA and Rt frontal lobe acute ischemic changes. (Patient apparently seemed to have right dominant language area) On DSA there was a significant ulcerated stenosis in Right ICA. Stenting with Xact stent 6-8x 30 with emboshield protection device was done

20/08/2023

Presenting an interesting and challenging case of Left main trifurcation angioplasty under image guidance at ICC Summit. The summit was a well-organized academic feast for interventional cardiologists. A big round of applause to the organizers and management for their efforts in making this event a success!

16/08/2023

We call it Distal left main Trifurcation angioplasty, they call it Stenting
We call it Primary angioplasty in a shock, they call it stenting
We call it CHIP, they call it Stenting
We call it Rotablation assisted angioplasty, they call it Stenting
We call it retrograde PCI in CTO, they call it Stenting
Here “WE” only understand what it means for rest it is just about Stenting

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06/07/2023

72 years old female acute inferior wall MI. Past history of stenting in RCA
CAG Severe disease in non dominant LCX, distal RCA (PLV) total occlusion. Mid RCA severe ISR with severe calcium (360 degree arc) identified on IVUS. Balloon dilitation of distal RCA with DEB. Rotablation of RCA with 1.5 mm burr UpTo middle of previously implanted stent followed by cutting balloon (wolverine) 2.75. Two overlapping stents. End result was fairly good. Rotablation is usually contraindicated in acute situation but there wasn’t any other option and we didn’t ablate the culprit lesion but proximal segment. Patient developed severe slow flow and CHB which was managed effectively. Procedure was done under IVUS guidance.

01/07/2023

Presenting my work at prestigious CSI-NIC. Total 3 cases of mine were selected.

25/06/2023

53 years old male had a cross over stent Left main-Early diagonal 2 years back jailing both LAD and LCX at some other centre. Most cardiologists would argue it to be a bad decision at that time but we don’t know the condition and circumstances under which the decision was made.
Now patient came with severe ISR and involving LM-LAD-Diagonal. Ostial LCX was also severely diseases as confirmed on IVUS. So it was a distal LM trifurcation disease. I advised the patient to go for bypass surgery considering his age and complexity which he outrightly denied. His words “either you stent or I die”.
So distal LM trifurcation LM-LAD-Diagonal staged Culotte and LM-LAD-LCX minicrush was done.
Most difficult part of the procedure was wiring of LAD across ISR segment which took around half an hour but finally success was achieved with Balloon dilation and Gaia 2 wire. Procedure was done with with IVUS support excellent stent apposition and final areas were achieved.

19/06/2023

Step by step demonstration of Double kiss Culotte in Dual LAD Bifurcation (Medina 111)

14/06/2023

When you are lucky enough to selectively cannulate the intended vein without additional effort. The vein is stenosed hampering the tracking of LV lead. Success achieved finally by balloon dilating the vein.

06/06/2023

Sharing a difficult but successful case of BMV. Very tight stenosis with valve area 0.7cm2 and severe PAH 70 mmHg. Valve was suitable for BMV assessed on TEE. Septal puncture was not a problem but balloon would not cross the Mitral valve. Tried all manoeuvres and jugaad that took almost 1 hour but all in vain. Finally 0.24 turemo wire (straight tip) was crossed but it would not give support to bulky balloon, so it was exchanged with 0.24 Teflon wire used for IABP insertion(my capable technicians Deepu and Naveen prompted me for this) and balloon was tracked on it. Valve dilated upto 25mm. Total procedure took 2 hours and 20 minutes (pretty long) but final result was excellent. Mean gradient went down to 4 mmHg and there was just trivial MR.