As a full time private practice cardiologist I have been to many live case meetings around the world. The overwhelming lesson I learn from these cases is what not to do!!

Often in lives cases equipment that has been around for 20 years gets pulled out and once again, and we are all told how good it is, i.e, IVUS, Roto, pressure wire. and that we don't use it enough etc, etc, etc.  99% of cases I do don't need IVUS, Roto, or pressure wire, but 100% of live cases use this stuff. It's like a broken record.

Often the operator has decided what to do already, they obtain the opinion of the panel and then do the exact opposite, the audience all groan, the result is as expected or worse, the operator justifies what he did saying that was the best option at the time.

I love live cases, but they can be a little condescending when talking to the audience. I know when a stent has been deployed in the proximal LAD with a 2.5mm balloon that it underdeployed, I don't need IVUS.

During an MI I do not IVUS the plaque after thrombectomy when flow has been restored at 0200 hours, just to remind myself what a ruptured plaque looks like. This has been suggested that it should be routine, this came out if a live case! And the whole panel all nodded their heads in agreemant!  Routine IVUS during and MI, give me a break.

Keep the live cases coming, keep them real, don't patronise the audience, we have all been doing angioplasty quite well for 20 years, (don't tell us how to suck eggs), don't use epuipment just because it is there, listen to the panel, if they suggest not treating  the lesion then leave it alone!! 

Keep up the Click and Rub, great listening!!

Cheers from Queensland, Australia.