Abdul Saadi

Scenes from a special Fourth of July celebration ahead of the Paraguay-France World Cup game 😲🇺🇸

An overhanging stent is difficult to deal with. Here’s a solution: Remove it and start fresh. This is one of few cases we’ve done at Henry Ford Hospital. All successful, no adverse events. doi.org/10.1016/j.jaccas.202… @HenryFordHealth @hfhcardiofellow @JACCJournals @KAlaswadMD

Here we go again: the MITRA-FR vs COAPT nightmare, revisited. Two LAAO trials, two different results—unsurprising, for many reasons. In CHAMPION-AF, among patients with atrial fibrillation, left atrial appendage closure was noninferior to NOACs for cardiovascular death, stroke, or systemic embolism, and superior for non–procedure-related bleeding. #ACC26 nejm.org/doi/full/10.1056/NE…

⚠️ Are we underestimating paravalvular leak after TTVR? In TRIPLACE, ≥Mod PVL occurred in 6.1% and was associated w/ 🔴39.7% 1-year mortality 🔴2.6X higher risk of death 🔴Less symptomatic improvement despite successful TTVR 🔗doi.org/10.1016/j.jcin.2026.… @azeemlatib Rishi Puri

First report of a fully percutaneous transcarotid TAVI using a collagen-based large-bore closure device (MANTA). The case demonstrated the feasibility of percutaneous carotid access and closure as an alternative strategy when transfemoral access is not suitable. eurointervention.pcronline.c… @parma @drnvanmieghem @modine_thomas #TAVI #StructuralHeart #InterventionalCardiology

You're called to a cardiac arrest, which has been going on for 10 minutes, end tidal CO2 is 6. Chest compressions appear to be of good quality. You place the TEE probe in the mid esophageal long axis and get this clip. What would you change? @alex1708ander @NephroP @ross_prager @RJonesSonoEM

🫀💊 The aspirin conundrum—solved (partly) by genetics This 2025 American Journal of Preventive Cardiology State-of-the-Art Review tackles one of the longest-running dilemmas in prevention: why does low-dose aspirin help some people—but harm others? The answer may lie in Lp(a) genetics . ⚖️ The classic problem In primary prevention, aspirin reduces myocardial infarction—but increases major bleeding to a similar extent. At the population level, benefits and harms cancel out, leading guidelines to largely step back from routine aspirin use. 🧬 Enter Lp(a) and the LPA genotype The review focuses on a specific LPA polymorphism (rs3798220), present in ~3–4% of individuals, strongly associated with: markedly elevated Lp(a) levels increased atherothrombotic risk Crucially, three large studies (Women’s Health Study, ARIC, ASPREE) show a consistent pattern: In LPA-negative individuals → aspirin provides minimal benefit (very high NNT: 250–800) In LPA-positive individuals → aspirin dramatically reduces cardiovascular events, bringing their risk down to the level of non-carriers 📊 The numbers matter In LPA carriers: Relative risk reduction: ~55–80% Absolute risk reduction: ~2.7–3% Number needed to treat (NNT): ~34–38👉 Comparable to, or better than, many statin trials. 🧠 Why this makes sense biologically Lp(a) promotes thrombosis via its plasminogen-like structure. Aspirin doesn’t lower Lp(a) levels—but may neutralize its pro-thrombotic effect. ⚠️ Important caveats Evidence is based on post-hoc genetic analyses Most data come from European ancestry Bleeding risk still exists and must be individualized 🔮 Bottom line This paper reframes aspirin not as a blunt population tool—but as a precision therapy. 👉 For most people, aspirin isn’t worth it. For a genetically defined few, it may be exactly right. 🧭 Sometimes, the problem isn’t the drug—it’s who we give it to.

Edwards Sapien M3 Transseptal TMVR System Approved by FDA | @EdwardsLifesci citoday.com/news/edwards-sap…

Grateful for the dedicated audience who came at 0800 on the last day of the #AHA25 to discuss multi-organ impairment in PAH.