Interventional Cardiologist | Ochsner Clinic Foundation, Slidell, Louisiana |
New Orleans, Louisiana
Joined July 2022
- Tweets987
- Following426
- Followers157
- Likes1.2K
Sunil Upadhaya, MD, FACP retweeted
🔥#TCT2026 Late-breaking Trials 🔥: TRANSFORM II
✍️ pcronline.com/News/Congress-…
@aayshacader and @NicolaRyanI1 review this randomised clinical trial that compared the outcomes of sirolimus coated balloons vs drug-eluting stents in native coronary vessels.
Presented by @BernardCortese in San Diego.
#interventionalcardiology #clinicalresearch #science
Sunil Upadhaya, MD, FACP retweeted
Our editorial comment on one of the largest studies of SPECT/PET myocardial perfusion imaging in very elderly published in Circulation: Cardiovascular Imaging
🔗 ahajournals.org/doi/10.1161/…
#cardiotwitter @CircAHA
Sunil Upadhaya, MD, FACP retweeted
SINGLE-CLOSURE: A single-ProGlide strategy may be noninferior for a composite of access-site or access-related vascular complications compared to conventional double-ProGlide closure following transfemoral #TAVR.
Read more: bit.ly/4yV0yLb
#JACC #TCT2026 @crfheart
Sunil Upadhaya, MD, FACP retweeted
Can the risk of bailout MCS during PCI be predicted? The ORACLE Score. Presented @crfheart #TCT2026 and published simultaneously @enricopoletti4 @LAzzaliniMD @DrPrimaroNg @DrBillLombardi @BMC2_ @UWMedHeart ahajrnls.org/4edC34n
Sunil Upadhaya, MD, FACP retweeted
🔥#TCT2026 Late-breaking Trials🔥: HD-PCI
✍️pcronline.com/News/Congress-…
@NicolaRyanI1 provides her take on this prospective cluster crossover registry-based trial comparing a strategy of low dose heparin to high dose heparin in patients undergoing elective PCI.
Presented by @SanjitSJolly in San Diego.
#interventionalcardiology #clinicalresearch
Sunil Upadhaya, MD, FACP retweeted
HD-PCI is the largest randomised comparison of heparin doses in elective PCI (11,619 patients), providing valuable evidence from routine practice. Some limitations deserve consideration: fewer events than anticipated (17%), registry-based event ascertainment, and lack of documentation of the actual dose delivered. In this context, 100 U/kg showed no apparent advantage over 70 U/kg, supporting a lower-dose strategy with ACT-guided top-up as a reasonable approach. #TCT2026
Sunil Upadhaya, MD, FACP retweeted
Presented at #TCT2026:
In a randomized trial, CCTA-guided PCI with structured preprocedural planning and intraprocedural guidance was noninferior to intravascular ultrasound–guided PCI with respect to target-vessel failure at 12 months. Full P4 trial results: nej.md/48jfVly
@crfheart
ALT A graph from the Original Article "Coronary CT Angiography versus Intravascular Ultrasound Guidance for PCI." The trial name, P4, is in parentheses after the title. The graph shows the cumulative incidence of target-vessel failure (primary end point), defined as a composite of death from cardiac causes, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization, at 12 months. The trial results are being presented at the Transcatheter Cardiovascular Therapeutics 2026 Conference. The logo of the New England Journal of Medicine is at the bottom.
Sunil Upadhaya, MD, FACP retweeted
IABP vs Impella for LV Unloading in VA-ECMO. Supply: demand improved with IABP but not Impella. Presented @crfheart #TCT2026 and published simultaneously @SaadEzad @divaka_perera @UKheartresearch @VPanoulas @PBSherren @K_DeSilva @DrMattRyan @hollymorgs ahajrnls.org/4icUqZy
Sunil Upadhaya, MD, FACP retweeted
✅ Two-parameter echo approaches work in chronic AR
🎯 In 214 Echo–CMR patients, 2 approaches anchored in LV remodeling, one requiring color Doppler, the other allowing any AR parameter, performed similarly to ASE algorithm with less quantitation needed.
doi.org/10.1016/j.jcmg.2026.…
Sunil Upadhaya, MD, FACP retweeted
⚠️ Unvisualised LCA during ACS: what went wrong?
This case by Gulbadin Mufti et al. highlights a rare prepulmonary anomalous LAD mimicking an LM total occlusion, featuring a unique bidirectional bifurcation.
🔗 asiaintervention.org/article…
@APSIC6 @EuroInterventio @PCRonline
Sunil Upadhaya, MD, FACP retweeted
I created LearnCoronary (learncoronary.com), an interactive tool designed to help general cardiology fellows and other early-career learners better understand coronary angiography and the spatial relationships between different angiographic views.
#cardiotwitter @OpenAI
Sunil Upadhaya, MD, FACP retweeted
🩺 ECG Challenge | *European Heart Journal – Case Reports
Bidirectional ventricular tachycardia in a young woman with prominent U waves: what is the diagnosis?
Can a careful ECG interpretation reveal the underlying disease? This educational ECG Challenge presents a young woman with bidirectional ventricular tachycardia and prominent U waves, guiding readers through the differential diagnosis and highlighting the importance of recognizing ECG clues to identify rare but potentially life-threatening inherited arrhythmic disorders.
📖 Test your diagnostic skills:
ow.ly/7GOw50ZX29u
#EHJCaseReports @KardiologieHH @aayshacader @ANazmiCalik @TJ_Yeo @FarhanaAra @cfcamm
Sunil Upadhaya, MD, FACP retweeted
✍️Coronary 🫀plaque burden and vulnerability are differently associated with Lp(a) and non–Lp(a) apoB particles. Assessing these lipoprotein pools separately may improve plaque characterization, while their ratio helps identify which particle type predominates.
Sunil Upadhaya, MD, FACP retweeted
Not all apoB-containing particles tell the same story.
🔹 Non–Lp(a) apoB → greater coronary plaque burden
🔹 Greater relative Lp(a) contribution → more vulnerable plaque features
New in #EJPC: Balance between apoB and Lp(a) may add another layer to cardiovascular risk assessment and personalized prevention. ow.ly/uL2650ZWCIC
@EJPCEiC @AboyansV @SilCastelletti @PTBuketAkinci @PeroneFrancesco @SMosteoru @TimKambic
Sunil Upadhaya, MD, FACP retweeted
Efficacy and Safety of Flecainide Versus Amiodarone for the Cardioversion of paroxysmal Atrial Fibrillation in Patients with Coronary Artery Disease without evidence of residual ischemia: The FLECA-ED Randomized Clinical Trial
heartrhythmjournal.com/artic…
Sunil Upadhaya, MD, FACP retweeted
Blinded withdrawal of randomized treatment with low-dose digoxin or placebo in heart failure: the DECISION trial academic.oup.com/eurheartj/a… #digoxin #heartfailure via @ESC_Journals
Sunil Upadhaya, MD, FACP retweeted
What I have learned about handling a Suoh wire from watching the experts.
1) The Suoh needs time and distance to work — keep the MC just off the dark part of the wire by default.
2) If the wire tip stops moving, bring the MC a bit closer, then try to advance the wire.
3) If the wire buckles close to the tip, back the MC and re-engage the epicardial loop
4) If the wire buckles away from the tip, bring the MC closer to swallow the buckle.
5) If the epicardial starts to accordion or make a wide loop, gently advance the MC and wire as a unit.
6) Spin the MC, not the wire when crossing a tight loop (if using a torquable MC)
Mentors @DrBIqbal, @KambisMashayek1, @RinfretStephane et al, feel free to add your own wisdom.
And, correct me where I got it wrong! 😅🙏🏼
Learning to Take the Path Less Traveled
Three of the best cases at @ctoessentials 2026 involved epicardial collateral crossing by the best in the business: @DrBIqba, @RinfretStephane, and Alex Nap.
I applied those lessons as soon as I returned to Houston! Here is the case. 😀
Sunil Upadhaya, MD, FACP retweeted
One of the most interesting anomalies i have ever seen. I see LAD from conus and LCX from PL . Any other suggestions? @realarainmd @SVRaoMD @SripalBangalore @ShariqShamimMD @abadkhan2002 @aymanka @mmamas1973
Sunil Upadhaya, MD, FACP retweeted
Invaginated. Then gone.
Incidental LA appendage invagination in a patient undergoing IMPELLA implantation #echofirst
⚠️ Beware of LAA invagination in patients with MCS. It can mimic pathology if you don’t recognize it.
LA appendage Invagination
#HRX2026 @Drdevignair
Done percutaneously with imaging #echofirst #yescct #innovation #CardioTwitter
Sunil Upadhaya, MD, FACP retweeted
I heard so many horror stories of fractured wires and trapped burrs that I play two steps ahead and prevent those issues:
- Change burr after ~4 min of drilling
- Move wire during ablation every 30 seconds
- Change wire after 5-6 min of drilling
With these measures, I never had any rota-induced perforation or burr entrapment that I couldn't solve by just pulling the wire.