A 79 year-old female presented with worsening dyspnea on exertion– NYHA class III and fatigue, with a history of hypertension, HPL, left breast CA, obesity, non-ischemic CM, non-obstructive CAD, gastric bypass (1983), left mastectomy with reconstruction (1985) and AICD (2010). TTE revealed Severe valvular aortic stenosis; peak gradient = 64 mmHg, mean gradient = 44 mmHg, Doppler valve area = 0.63 sq cm, Ao peak CW velocity = 4 m/sec, LVEF 33 %. CT angio showed minimum diameters of >6 mm for bilateral common femoral arteries and aortic annulus of 2.6 X 2.2 cm (average 2.45 cm). The STS risk mortality is 3.0 % and the Logistic Euroscore mortality is 6.7%. Patient was determined to be high risk for surgical AVR due to history of breast CA (post radiation therapy) and non-ischemic cardiomyopathy. Patient is now planned for Evolut-R CoreValve TAVR (29 mm) via percutaneous femoral access under conscious sedation.
Mitral ViV TMVR using SAPIEN-3 Valve – May 2019
81 year old female presents with worsening dyspnea on minimal exertion (NYHA class III) over the last few months. Her past medical history is significant for rheumatic heart disease with severe MR and MS s/p bioprosthetic MVR with 29 mm porcine valve (Biocor, St. Jude Medical) along with MAZE procedure in 2007. She also has […]
Valve-in-Valve TAVR with 26mm SAPIEN-3 – March 2019
79 year old man presents with worsening exertional dyspnea (NYHA Class III) for the last 3 months. Patient has required multiple recent admissions to hospital with CHF exacerbation requiring IV diuretics. Past medical history is significant for symptomatic bicuspid aortic valve with dilated ascending aorta s/p Bentall procedure (2011) with 25 mm Carpentier-Edwards pericardial valve […]
Valve-in-Valve TAVR with 29mm Evolut-R CoreValve – January 2019
79 year old man presents with progressive exertional dyspnea (NYHA Class III) for the last 2 months.