An 83 year-old female presented with worsening dyspnea on exertion– NYHA class III and fatigue, with a history of hypertension, Atrial Flutter s/p PPM, moderate COPD, Septal Hypertrophy s/p ablation, kyphosis, and Rt. Breast CA s/p radiation. TTE revealed severe AS, peak/mean aortic gradient = 79/49 mmHg, AVA = 0.5 sq cm, aortic peak velocity = 4.4 m/sec and LVEF 57%. CT angio showed minimum diameters of 0.8 x 0.9 cm for right and 0.8 x 0.9 cm for left common femoral arteries and aortic annulus of 2.4 X 1.8 cm (average 2.1 cm). The STS risk mortality is 5.8% and the Logistic Euroscore mortality is 14.7%. Patient was determined to be high risk for surgical AVR due to COPD and frailty. Patient is now planned for Evolut-R CoreValve TAVR (26mm) via percutaneous femoral access under conscious sedation.
79 year old man presents with progressive exertional dyspnea (NYHA Class III) for the last 2 months.
96 year old male presents with progressive exertional dyspnea (NYHA Class III) for the last 4 months.
87 year old female presents with progressive exertional dyspnea (NYHA Class III) for the last 3 months.
87 year old male with known history of mitral regurgitation, hypertension, hyperlipidemia, CAD s/p DES PCI to RCA (2010 and 2015), ischemic cardiomyopathy, carotid artery stenosis, and frailty presents with worsening dyspnea on exertion NYHA Class III for 6 months.