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PODCAST

The Murmur Pod

The Murmur Pod is hosted by Dr. Aidan Raney III and Dr. Joe Walsh. Specializing in interventional cardiology, they explore happenings in the cardiology and medical communities, discuss interesting cases, review new technology, and more. This podcast is presented first in the MurmurMD App! Work in the cath lab? Reach out to join the private community there!

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All Episodes

00:16:29

Common Femoral Disease Without Surgery? Two High-Risk...

The Murmur Pod ·

2025/12/29

Redo groins, radiation injury, prior infection, and failed bypasses make common femoral artery disease some of the most difficult decisions in vascular care.In this case-based discussion, Dr. Nick Mouawad and Dr. Sameh Sayfo walk through two challenging common femoral artery cases where traditional open surgery carried high risk.Topics covered include:• Managing CFA bifurcation disease after prior radiation and surgical complications• Why the profunda femoris artery must always be protected•

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00:33:31

Leaflet Modification: Basilica, Shortcut, and the...

The Murmur Pod ·

2025/12/18

Leaflet modification has rapidly evolved from niche innovation to a cornerstone of lifetime TAVR management.In this discussion, Dr. Toby Rogers joins Dr. Andrei Pop to explore the latest data, device advances, and clinical decision-making behind Basilica, Shortcut, and emerging techniques like Telltale, Unicorn, and leaflet excision.Key topics covered:History of leaflet modification — from LAMPOON to BASILICA and now device-guided proceduresHow Shortcut and Telltale are changing training and

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00:17:19

Fixing a Calcified LIMA: Rota, Shockwave, and DCB in...

The Murmur Pod ·

2025/12/10

LIMA interventions are rare, high-risk, and technically unforgiving. In this MurmurMD case session, Dr. Arvin Narula and Dr. Joe Walsh walk through an extremely challenging LIMA-to-LAD lesion involving heavy calcification, tortuosity, failed prior PCI, device entrapment, rotational atherectomy, Shockwave IVL, and management of unexpected graft thrombus.This discussion delivers real-world strategy, troubleshooting, and device thinking you won’t find in textbooks.Key insights from the case:• Why left

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01:18:00

Mastering PASCAL in Complex Mitral Anatomy: Strategy,...

The Murmur Pod ·

2025/12/04

Complex mitral valve anatomy continues to challenge even the most experienced TEER operators. In this month's SWAC conference, Dr. Sergio Garcia, Dr. Tom Waggoner, Dr. Mark Bieniarz, and Dr. Aidan Raney walk through how to approach PASCAL therapy in anatomies where leaflet length, clefts, stenosis, and calcification make decision-making difficult.Using multiple real patient examples, they break down:• How PASCAL’s separatable clasps change strategy in short posterior leaflets• When to choose

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00:24:51

Common Femoral Artery Intervention: Surgery vs IVL –...

The Murmur Pod ·

2025/12/01

The common femoral artery has always been considered a surgical zone—but with today’s endovascular technology, should that dogma be challenged?In this MurmurMD session, vascular surgeon Dr. Nick Mouawad joins Dr. Sameh Sayfo for a deep dive into how modern tools (IVUS, intravascular lithotripsy, advanced classification systems, and hybrid-OR workflow) are reshaping the way we evaluate and treat common femoral artery disease.Using real-world experience and early data from investigative studies, the

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00:23:14

CTO PCI Simplified: Dr. Robert Riley’s Step-by-Step...

The Murmur Pod ·

2025/11/24

ADR (Antegrade Dissection and Re-Entry) has historically been viewed as unpredictable — but with a structured, IVUS-sighted approach, it becomes one of the most consistent and controllable CTO PCI techniques.In this detailed case walkthrough, Dr. Robert Riley demonstrates how he performs an IVUS-Sighted ADR workflow during a complex RCA CTO. He explains how to select landing zones, create a controlled knuckle, prevent hematoma formation, orient the Stingray system correctly, and re-enter the true

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00:27:56

TAVR Valve Choice, Coronary Access, and the Lifetime...

The Murmur Pod ·

2025/11/17

TAVR isn’t just a procedure anymore — it’s a lifetime management decision.In this in-depth case discussion, Dr. Matt Summers and Dr. Aiden Raney dive into how hemodynamics, modeling tools, and device design are reshaping how operators approach valve selection, coronary access, and reintervention planning.Key insights include:Real-world cases showing how valve selection has evolved since 2018Using DASI modeling to predict sinus sequestration and coronary riskHow Shortcut has simplified bilateral

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00:30:31

How AI and Predictive Modeling Are Changing TAVR...

The Murmur Pod ·

2025/11/04

TAVR has come a long way—from a high-risk bailout procedure to a precision-driven, patient-specific therapy.In this MurmurMD case discussion, Dr. Matt Summers (Sentara Heart Valve Center) joins Dr. Aiden Raney to explore how new data, AI modeling, and simulation tools like DASI are transforming how interventionalists choose between self-expanding and balloon-expandable valves. A real look into contemporary approaches to valve therapy decisions.Key insights covered:The evolution from procedural

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01:01:52

From Idea to Market: How to build a medical device...

The Murmur Pod ·

2025/10/27

Physicians Building Devices: Powering the Next Wave of Cardiovascular InnovationNot in boardrooms—but in cath labs, by operators sharing cases, data, and ideas in real time.In this episode, Dr. David Daniels and Dr. Joe Walsh dive into how platforms like MurmurMD are connecting physicians, engineers, and startups to accelerate device innovation from the front lines of interventional cardiology.Key themes and insights:Why innovation starts with operators identifying real problems in the labHow

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00:25:55

ALT-FLOW II Trial: Shunting Innovation for HFpEF and...

The Murmur Pod ·

2025/10/23

Can creating a shunt between the left atrium and the coronary sinus improve symptoms for patients with heart failure with preserved ejection fraction (HFpEF)?In this in-depth discussion, Dr. Andrei Pop and Dr. Firas Zahr, PI of the ALT-FLOW II Trial, explore the science, physiology, and patient selection behind one of the most intriguing new frontiers in interventional heart failure.Key takeaways:What makes ALT-FLOW different from previous intra-atrial shunt devicesHow shunt location, size, and flow

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00:20:26

Impella 5.5 for AVR: Surgical Strategy, Weaning, &...

The Murmur Pod ·

2025/10/18

How do surgeons decide when to place an Impella 5.5 before valve surgery?In this discussion, Dr. Roland Hernandez walks through his operative approach with Dr. Chris Brown, covering:Patient selection: when balloon pump isn’t enough supportStep-by-step technique for direct aortic Impella 5.5 insertionHow to tunnel and remove the graft safelyTechnical pearls for cross-clamp position and avoiding floodingStrategies for weaning from bypass to ImpellaCommon hazards: wire and catheter challenges for

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00:32:28

TAVR-in-TAVR Gradients Explained: Flow, Expansion &...

The Murmur Pod ·

2025/10/09

What really drives gradients after TAVR-in-TAVR—and do they actually matter?In this conversation, Dr. Amr Abbas and Dr. Andrei Pop break down the nuances behind gradient measurements, patient-prosthesis mismatch (PPM), and valve expansion strategy in redo TAVR.Key takeaways include:Why echo gradients differ from invasive gradients even under identical hemodynamicsUnderstanding discordance between flow and pressure in post-TAVR assessmentWhy PPM is less concerning in normal-flow patients than

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00:23:00

DEFINE GPS Trial: Physiologic PCI Guidance,...

The Murmur Pod ·

2025/10/04

How often do patients leave the cath lab with residual ischemia—and can physiologic guidance change outcomes?In this discussion, Dr. Chris Brown and Dr. Christian McNeely review insights from the DEFINE GPS Trial, where PCI guided by pressure wire co-registration was compared with angiography alone.Key highlights:- Why 20% of patients left the lab with residual ischemia in DEFINE PCI- How FFR/iFR pullback and co-registration create a physiologic roadmap for stenting- Trial design, enrollment (2,100

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00:56:06

LAAC Imaging in 2025: 3D ICE vs TEE—Techniques,...

The Murmur Pod ·

2025/09/23

How is left atrial appendage closure (LAAC) evolving in 2025—and what’s the role of 3D ICE vs TEE?In this SWAC session, Dr. Matthew Price and panelists share their real-world experiences and expert pearls:Why 3D ICE is becoming the standard for Watchman and Amulet proceduresKey tips to avoid air embolism and manage sedation risksHow to safely perform ICE-guided transseptal puncture and LAA imagingWhen TEE or mini-TEE probes remain the better optionCost, staffing, and program scaling strategies for

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00:26:07

Conscious Sedation LAAO with ICE: Building a...

The Murmur Pod ·

2025/09/13

Can you safely perform left atrial appendage occlusion (LAAO) without TEE, anesthesia, or an echo doc?In this episode, Dr. Raghava Gollapudi (San Diego Cardiac Center) and colleagues break down how they built a conscious sedation, ICE-only LAAO program in private practice. They cover:- Why traditional TEE + anesthesia models slow scheduling and add variability- Evidence from Europe showing ICE-only Watchman is safe- How to transition from TEE support to ICE-only workflow- Practical pearls for ICE

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00:39:52

How to Build a World-Class Research Program: Lessons...

The Murmur Pod ·

2025/09/08

A look into how Dr. Waggoner took a new TAVR program and transformed it into a top-tier research hub from scratch! Dr. Tom Wagner, Director of Structural Heart at Tucson Medical Center, shares his journey in building a research-first culture from scratch. In this conversation, he discusses:Why research is a differentiator in regional cardiologyHow he grew from zero research to 70+ active clinical trialsThe inflection point when a program takes off (around year 5)The importance of volume, outcomes,

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00:36:12

The Ross Procedure: Modern Techniques, Durability, &...

The Murmur Pod ·

2025/08/30

Once considered niche, the Ross procedure is making a strong comeback. With improved techniques and long-term outcomes, it’s becoming a first-line option for younger patients with aortic valve disease.In this episode, Dr. Chris Malaisrie (Northwestern Memorial, Chicago) joins Dr. Andrei Pop to discuss:Why the Ross procedure is resurging in high-volume centersTechniques to stabilize the autograft and prevent dilation (deep LVOT implant, Dacron grafts, wrapping with native root)Post-op strategies

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00:29:12

TAVR Explant: Why Mortality Is Dropping & How...

The Murmur Pod ·

2025/08/23

TAVR explants were once considered high-risk, last-resort surgeries—with mortality rates as high as 18–20%. But recent data and surgical advances are changing the conversation.In this episode, Dr. Tsuyoshi Kaneko, Director of Cardiothoracic Surgery at Washington University in St. Louis, joins Dr. Andrei Pop to discuss:Why TAVR explant rates are rising and who needs themHow mortality has dropped to 5–6% in recent seriesThe impact of standardized techniques and better patient selectionStrategies for

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00:43:21

Changing the Paradigm of Aortic Stenosis Treatment...

The Murmur Pod ·

2025/08/16

PCI in Complex CAD: Imaging, Physiology & Patient-Centered Decision Making with Dr. Philippe Genereux, Dr. Joe Walsh, and Dr. Aidan RaneyWhat role should imaging and physiology play when tackling complex CAD?In this condensed discussion, Dr. Philippe Genereux (Morristown Medical Center) shares his approach to optimizing PCI and balancing data, experience, and patient outcomes. Key takeaways include:When to rely on FFR vs IVUS/OCT in PCI decision-makingCase selection pearls in left main and

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00:29:26

Building a High-Risk PCI & Shock Program Without...

The Murmur Pod ·

2025/08/06

Can you build a complex PCI and cardiogenic shock program in a community hospital without surgical backup?Dr. Mahesh Ananta shares his journey from type A/B PCI to performing Impella-, ECMO-, and CTO-supported interventions in a small hospital setting. Learn how he:Scaled a high-risk PCI program with minimal resourcesImplemented Impella and ECMO safely without in-house CT surgeryJoined a cardiogenic shock network to improve outcomesNavigated hospital culture and financial conversationsTrained staff

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29 results

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