67 year old male presents with worsening dyspnea on exertion (NYHA class III) and edema over the last 4 weeks. Past medical history is significant for severe MR s/p bioprosthetic MVR in 1997 with subsequent degeneration and replacement with a #29 Hancock II porcine bioprosthetic valve in 2008. Patient had mitral paravalvular leak s/p transcatheter closure. Also had severe TR s/p Tricuspid Valve Repair (#26 Cosgrove Band) 2008, atrial flutter and atrial fibrillation s/p multiple ablations and s/p Cryomaze in 2008, cirrhosis, CKD stage 3, remote GI bleed, COPD, and severe pulmonary hypertension. A recent TEE showed a severely degenerated mitral valve bioprosthesis with a flail leaflet and severe transvalvular MR along with moderate bioprosthetic MV stenosis (MG = 9-11 mmHg). The patient was evaluated by the Heart Team and due to his multiple comorbidities and STS mortality of 7.12%, was found to be extreme risk for a 3rd reoperation. Patient is now planned for a ViV TMVR with a 29 mm Sapien-3 valve via transfemoral approach.
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.