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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

00:22:55

Stent Thrombosis Management: IVUS-Guided Strategy and...

The Murmur Pod ·

2026/04/20

Stent thrombosis is one of the most high-stakes complications in PCI — and getting the mechanism right is everything.In this MurmurMD case discussion, Dr. Nyal Borges and Dr. Joe Walsh walk through a real-world case of stent thrombosis, focusing on how intravascular imaging (IVUS) guides diagnosis and how drug-coated balloons (DCB) fit into the treatment strategy.Key discussion points from the transcript include:• Identifying the underlying cause of stent thrombosis• Why angiography alone is

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00:35:27

Case Discussion- TAVR Valve Implantation Techniques:...

The Murmur Pod ·

2026/04/17

Successful TAVR depends on precise positioning, controlled deployment, and a clear procedural strategy.In this MurmurMD discussion, Dr. Nathan Frogge and Dr. Matthew Summers review key TAVR valve implantation techniques (highlighting Cusp Overlap), focusing on how to optimize positioning, manage deployment, and improve procedural outcomes.Key discussion points from the transcript include:• Planning valve positioning before deployment• Understanding anatomy and fluoroscopic views• Controlling implant

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00:26:35

Two Layers of Stent in the Ostial RCA: Strategy,...

The Murmur Pod ·

2026/04/04

Ostial RCA disease can be one of the most unforgiving lesions in coronary intervention — especially when multiple layers of stent are already present.In this MurmurMD case discussion, Dr. Nyal Borges and Dr. Joe Walsh review a challenging PCI involving two layers of stent at the ostial right coronary artery, focusing on how imaging and careful technique guide treatment decisions.The discussion walks through the key procedural considerations in managing complex ostial stent anatomy, including:•

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00:34:01

Cusp Overlap Technique for SEV: Deep Dive on...

The Murmur Pod ·

2026/03/31

The cusp overlap technique has become an important strategy during TAVR with self-expanding valves to improve implant depth control and reduce conduction disturbances.In this MurmurMD discussion, Dr. Nathan Frogge and Dr. Matthew Summers walk through how and why they use the cusp overlap technique, focusing on fluoroscopic positioning, implant depth control, and procedural workflow adjustments.Key discussion points from the transcript include:• Why implant depth is critical in self-expanding TAVR

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00:26:30

TAVR Valve Durability: Long-Term Outcomes, Unknowns,...

The Murmur Pod ·

2026/03/20

As TAVR expands into younger and lower-risk populations, valve durability has become a central question in structural heart care.In this MurmurMD discussion, Dr. Curtiss Stinis and Dr. Andrei Pop review current understanding of TAVR valve durability, focusing on how clinicians interpret available data and apply it to real-world patient decisions.The conversation highlights key themes from the transcript, including:• How durability data for TAVR has evolved over time• The challenges of comparing

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00:15:25

When a Patient is told they have no options: Complex...

The Murmur Pod ·

2026/03/14

Complex coronary PCI often requires careful planning, imaging, and stepwise escalation of technique to achieve a safe and durable result.In this MurmurMD case discussion, Dr. Chris Brown and Dr. Eric Rothstein review a challenging coronary intervention and walk through the decision-making process used throughout the procedure.The conversation highlights key aspects of managing difficult coronary anatomy, including:• Assessing lesion complexity and procedural risk• Planning the intervention strategy

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00:34:48

LAVA ECMO in Structural Heart Procedures: Hemodynamic...

The Murmur Pod ·

2026/03/10

Structural heart interventions increasingly involve patients with severe ventricular dysfunction, valvular shock, or limited hemodynamic reserve. In these cases, maintaining stability throughout the procedure can be the biggest challenge.In this MurmurMD discussion and case review, Dr. Gennaro Giustino and Dr. Andrei Pop review how LAVA ECMO (Left Atrial Veno-Arterial ECMO) can be used to support patients undergoing complex structural heart interventions.The conversation walks through practical

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00:22:45

Cardiogenic Shock Case Discussion: Recognizing Shock...

The Murmur Pod ·

2026/03/07

Cardiogenic shock cases demand rapid recognition, structured thinking, and decisive escalation of support.In this MurmurMD case discussion, operators review a complex patient presentation with cardiogenic shock and walk through the clinical reasoning that guided management decisions.The conversation focuses on practical decision-making during shock physiology, including:• Recognizing early signs of cardiogenic shock• Interpreting hemodynamics and clinical presentation• Understanding when medical

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00:14:49

Iliac CTO Case Series: Radial R2P, Externalization,...

The Murmur Pod ·

2026/02/25

Iliac CTO interventions follow patterns — but recognizing them in real time is what separates a difficult case from a controlled one.In this MurmurMD case discussion, Dr. Jay Mohan and Dr. Sameh Sayfo walk through two iliac CTO interventions, highlighting practical lessons in access strategy, crossing techniques, IVUS guidance, and covered stent deployment.Key concepts discussed directly from the transcript include:• Why ABI can appear normal despite severe inflow disease• Using waveform analysis

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00:55:19

TAVR Explant: When, Why, and How to Safely Remove a...

The Murmur Pod ·

2026/02/17

As TAVR expands into younger and lower-risk populations, TAVR explant is no longer a theoretical problem — it’s a real and growing clinical scenario.In this MurmurMD discussion, Dr. Clinton Kemp and Dr. Matt Summers walk through the indications, technical challenges, and operative considerations involved in TAVR explant, emphasizing why early planning and multidisciplinary alignment are critical for patient outcomes.Topics covered directly from the transcript include:• Common indications for TAVR

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00:24:58

Iliac CTO Masterclass: Access, IVUS, Re-Entry, IVL,...

The Murmur Pod ·

2026/02/09

Iliac CTOs are among the highest-risk, highest-reward procedures in peripheral intervention. In this MurmurMD session, Dr. Jay Mohan joins Dr. Sameh Sayfo to break down their full approach — from diagnosis and CTA planning to crossing strategies, re-entry methods, IVUS, vessel prep, and stent selection.This case-driven conversation is packed with pearls on how to handle complex iliac occlusions safely and predictably.What you’ll learn from this transcript-based discussion:• Why PVR and waveform

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00:31:16

BiPella in Acute MI Shock: When Biventricular...

The Murmur Pod ·

2026/02/02

Not all cardiogenic shock after acute MI is left-sided — and treating it like it is can be fatal.In this MurmurMD case discussion, Dr. Chris Brown walks through a young patient with acute MI, progressive shock, and severe right ventricular failure, highlighting how early recognition and biventricular mechanical support (Bipella physiology) stabilized the patient when inotropes and balloon support failed.This transcript-based conversation focuses on real-time decision-making, including:•

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00:43:27

How to Build a High-Functioning Valve Clinic:...

The Murmur Pod ·

2026/01/29

A successful valve program isn’t built in the cath lab alone — it’s built in the clinic, the workflow, and the team structure behind the scenes.In this MurmurMD discussion, Dr. Andrei Pop and Caitlin O'Callaghan Reen, CNP, FACC walk through how they’ve structured and scaled a high-functioning valve clinic, covering everything from referrals and imaging to staffing models and follow-up.The conversation breaks down what actually works in day-to-day practice, including:• Why valve clinics must be

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00:21:34

Watchman TruSteer deep dive & Cases Steering,...

The Murmur Pod ·

2026/01/14

In this MurmurMD discussion, Dr. Raghava Gollapudi and Dr. Arvin Narula break down how the Watchman TruSteer sheath changes left atrial appendage occlusion (LAAO) workflows — from transeptal access to final device deployment.The conversation focuses on real-world use, and highlights when TruSteer adds value, how it improves coaxiality, and why many operators are moving toward using it routinely.Topics covered in this transcript-based discussion include:• Why earlier Watchman sheaths limited depth

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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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