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good morning and welcome for all around the world to structural hard life cases broadcasting directly from mount sinai hospital in the cardiac cath lab my name is pedro moreno im interventional cardiologist and professor of medicine and i will be your moderator today we would love to hear from you so please send us all your questions directly from the website or on youtube and remember all our previous cases structural cases can be seen in our website and now im going to transfer you to dr sharma and dr kinney for a very interesting case all right pedro we are getting ready here and of course a lot of challenges in this little bit of i would say minor uptick in the kobe cases with my team here uh myself dr gilbert tang on the right side heard upside here on the left side and dr kinney and our fellow prashanth and rest of the staff staff including uh we have our echocardiographer dr laracas and anesthesiologist dr benjamin salter and rest of catholic staff welcom