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.
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.