Father, Professor, Interventional Cardiologist, researcher, free thinker, athlete possibly
Flemingston, Wales
Joined July 2009
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Richard Anderson retweeted
Castle Course, St Andrews, Scotland, 2008 David McLay Kidd
Catching up on some posts from my Sept Scotland trip, the Castle Course of St Andrews was a new to me, first time playing. Located just south of the city, the views might be the best of any course in the area. Simply stunning scenery. The course is a modern interpretation of Scottish seaside golf, built on elevated coastal farmland overlooking St Andrews Bay and the North Sea.
Rather than following the classic Old Course/classic links pattern of playing outward and returning along a relatively narrow strip of land, the Castle Course circulates through its elevated property, repeatedly changing direction and exposing golfers to different winds. Extensive earth moving was done to create this modern links course.
The fairways feature large, irregular mounds and ridges that create uneven stances with significant changes in elevation, producing blind and partially obscured shots. The landing areas are very sloped and influence both the bounce and the direction of the golf ball as the conditioning is incredibly firm and fast. The bunkering is rugged, deep, and visually imposing. Unlike the relatively small pot bunkers commonly associated with traditional links, many Castle Course bunkers are integrated into large artificial landforms.
The green complexes are arguably the most distinctive and controversial elements of Kidd's design. They feature extraordinarily bold internal contours, including substantial slopes, ridges, shelves, and collection areas.
In some locations, relatively small errors in approach-shot positioning could produce exceptionally difficult recovery putts or chips. They are my only complaint of the course. Just a little too severe of contouring in my opinion.
All in all I would describe the Castle Course as a bold, visually spectacular, modern interpretation of Scottish links golf, rather than an authentic traditional links course.
Its greatest achievement is the transformation of relatively ordinary farmland into a memorable golfing landscape with an exceptional coastal finish. After a couple holes, I threw out all ideas of trying to score and just had fun with what the course presented. The winds were blowing 25+ mph so playing the ground game was even more fun.
I highly recommend adding the Castle Course to your St Andrews itinerary. The views of the town, the North Sea, and the visually stimulating course features along with just being a fun golf course, make it a must play.
Richard Anderson retweeted
At 10 years, the DECISION-CTO RCT found no difference for MACE with an initial CTO-PCI strategy vs no CTO-PCI, and the same applied to mortality alone. Is this the last nail in the coffin for CTO PCI? #CTO #PCI #TCT jacc.org/doi/10.1016/j.jacc.…
Richard Anderson retweeted
I just reviewed the PCI report, the Cardiologist predilated the proximal LAD with a 2.5 mm balloon at nominal pressure, then put a 3 mm DCB, claims to have used IVUS guidance, there is no way a NC 2.5 mm POBA at nominal pressure will adequately prepare a proximal LAD for DCB.
Richard Anderson retweeted
A Photographer’s Paradise 📸
From the links and dunes to Harlech Castle, the mountains beyond and the quieter details around the clubhouse, there’s no shortage of inspiration at Royal St David’s.
A few of our favourite frames from around the club.
Richard Anderson retweeted
Congrats to Ospreys. when are the WRU going to stop being pig-headed and when will they inform the four regions (all improving themselves) that they arê there for ever and that a tiny group of English non-experts have no right to kill them off.
The pitch is being laid at St Helen's 🏟️
Ospreys Director Roger Blyth, Leader of @SwanseaCouncil Rob Stewart and Cabinet Member for Environment and Infrastructure Andrew Stevens, visited St Helen's today to watch the roll out 👀
📰 ospreys.info/4d83yM0
#OurBloodIsBlack
Richard Anderson retweeted
No free lunch. In our meta-analysis, now published in JAMA Cardiology, transcatheter left atrial appendage closure (LAAC) was associated with similar long-term risks of any stroke and major bleeding compared with oral anticoagulation in patients with atrial fibrillation, while increasing the risk of ischemic stroke and reducing the risk of nonprocedure-related major bleeding.
Article: jamanetwork.com/journals/jam…
Editorial: jamanetwork.com/journals/jam…
Richard Anderson retweeted
delighted that the driven Hayley Parsons, has called for WRU board to resign. David Reddan’s plans were rejected by crushing majorities the wru arê so slow, lack off key expertise. Next step to ditch them inc Tierney and temporary chair man
—
Richard Anderson retweeted
Great analysis of #CHIPBCIS3 hemodynamic substudy,
The longer and more extensive revascularization you do in the same setting, the worse the outcomes!
I never bought into the narrative of "if you have MCS in place, complete revascularization in the same setting"
I have always believed staging is the correct way to complete revasc for many reasons, now I have an additional one.
🧵 New @JACCJournals study from #CHIP-BCIS3 provides an important physiologic look at #Impella-supported high-risk #PCI—and challenges how we think about “protected PCI.”
The key message: hemodynamic support ≠ myocardial protection.
1/6
Richard Anderson retweeted
A tour de force of appraisal. Bottom line: CHAMPION is not close to showing non-inferiority to DOAC
Reappraising CHAMPION AF. Does Placebo Meet Non-Inferiority in Stroke Prevention? #OpenAccess
heartrhythmjournal.com/artic…
Richard Anderson retweeted
Debunking debulking
DUAL-PREP OCT by Sotomi and colleagues highlights one of the oldest assumptions in complex PCI. Atherectomy produces remarkably little visible calcium fracture and removes relatively little calcium. So what is its principal role if not debulking. Mechanical priming? PREPing calcium for fracture and expansion?
📖 Editorial: ahajournals.org/doi/10.1161/…
📖 DUAL-PREP OCT substudy: ahajournals.org/doi/10.1161/…
A pleasure collaborating with @HirofumiOhashi @KoshiroSakai_MD.
Congratulations to Yoshinobu Sotomi and colleagues on an elegant mechanistic study.
@OPCILive @StFrancis_LI @SVRaoMD @CircIntv
#PCI #OCT #IVL #Atherectomy #CoronaryCalcium
Richard Anderson retweeted
Although once a GP, Lyn did not recognise #aorticstenosis in himself. When an investigation showed he had heart disease he was worried, but nowadays barely remembers he even had a procedure. Read his story: heartvalvevoice.com/lyn-grif…
#patientvoice #heartvalvedisease #patientstory
Richard Anderson retweeted
Jürgen Klinsmann: “There were 70,000 people, we were warming up seriously. While ‘Live Is Life’ was playing, Maradona started juggling the ball. We stopped warming up, because there was nothing more we could do except watch him.”
Richard Anderson retweeted
Does routine complete revasc after STEMI really stack up? Here’s our case against the motion……
📚 New #ICRJournal Article: "Complete Revascularisation in STEMI: Do We Really Buy It?"
📚 Just Published!
🔓Access it here 👉 ow.ly/ytWF106yE1R
@ncurzen #CVImaging #MedEd #VascularDisease
Richard Anderson retweeted
Castell Harlech has watched over this landscape for 700+ years. Built by Edward I, it has endured rebellion, siege and shifting tides—now overlooking Royal St David’s, where the game unfolds beneath its shadow.
Richard Anderson retweeted
🫀 Myocardial perfusion imaging (MPI) is routinely used to assess ischaemia in CTO patients—but does it actually predict outcomes after PCI?
This large registry study provides an important answer.
✨ Study at a glance:
🔹 319 patients undergoing CTO-PCI
🔹 65% had moderate–severe ischaemia (≥10% LV)
🔹 Follow-up: 90 days + 5 years
✨ Key findings:
🔹 No difference in hard outcomes between groups:
➡️ all-cause mortality
➡️ MACCE (MI, stroke, HF, CV death)
🔹 At both 90 days and 5 years:
👉 ischaemia burden did NOT predict prognosis
📊 But here’s the nuance:
🔹 Patients with higher ischaemic burden had:
➡️ lower risk of angina hospitalisation at 5 years
👉 Suggesting a greater symptomatic benefit from CTO-PCI
⚠️ Important considerations:
👉 Ischaemia defined globally (≥10% LV), not vessel-specific
👉 Mix of SPECT and PET imaging
👉 No comparison with medical therapy alone
💡 Clinical take-home message:
👉 Ischaemia is not a prognostic marker after CTO-PCI
👉 But it may help identify patients:
✔ more likely to benefit symptomatically
✔ with greater improvement in quality of life
🧠 This reinforces a growing concept:
👉 CTO-PCI should be:
symptom-driven, not ischaemia-driven
👉 Imaging should guide selection—but not dictate it
🚨 Bottom line:
More ischaemia ≠ better outcomes—only better symptom relief.
#Cardiology #CTO #PCI #Ischaemia #CardiacImaging #PET #SPECT #CoronaryArteryDisease #InterventionalCardiology #QualityOfLife 🫀📊
Richard Anderson retweeted
I was up last night with a STEMI until 4:30. For my entire career I’ve gone to work the next day with whatever sleep I could get. Not anymore. Today, I slept in and did chart work from home. You can’t fly an airplane or drive a truck if you’ve been up all night. Why should it be different for docs?
