84 year old female presented with chest pain and dyspnea on exertion (NYHA III). Her past history was significant for hypertension, hyperlipidemia, and DVT. TTE revealed severe valvular aortic stenosis; peak gradient = 68 mmHg, mean gradient = 41 mmHg, Doppler valve area = 0.7cm2, Aortic peak velocity = 4.1m/sec and LVEF of 51 %. Coronary angiogram showed mild (30-50%) mid LAD disease only. CT angiogram revealed minimum diameters of 8mm for bilateral common iliac arteries and aortic annulus of 21.6 X 26.7mm (average 24.4 mm) with an annular circumference of 75mm. Coronary ostial height was 10mm for left main and 15mm for RCA. The STS mortality risk for Surgical AVR is 3.4 % and the Logistic Euroscore mortality risk is 10.1%. Patient was determined to be intermediate risk for SAVR. Now planned for high risk TAVR with Sapien S3 (26mm) via percutaneous femoral access under conscious sedation and pre-empt LM protection.
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.