An 88 year-old female presented with progressive shortness of breath – NYHA class III, with a history of hypertension, chronic diastolic HF, COPD and s/p BAV on 7/2/15. TTE revealed severe AS, peak/mean aortic gradient = 65/44 mmHg, AVA = 0.6 sq cm, aortic peak velocity = 4 m/sec and LVEF 65%. CT angio showed minimum diameters of 0.4 x 0.7 cm for right and 0.6 x 0.6 cm for the left common femoral arteries and aortic annulus of 2.5 x 2.1 cm (average 2.3). The STS risk mortality is 5.15 and the Logistic Euroscore mortality is 12.81. Patient was determined to be extreme risk for surgical AVR due to advanced age and marked, generalized frailty. Patient is now planned for CoreValve Evolut R 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.