Structural heart cases
Valve-in-Valve TAVR with 29mm Evolut-R CoreValve – January 2019

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79 year old man presents with progressive exertional dyspnea (NYHA Class III) for the last 2 months. Past medical history is significant for CABG (SVG to D1 and SVG to RPL) & bioprosthetic surgical AVR (25mm Perimount 2700) in 03/09/04, atrial flutter s/p ablation, hypertension and hyperlipidemia. Recent echocardiogram revealed severe bioprosthetic aortic regurgitation due to leaflet degeneration and coaptation gap, moderate prosthetic aortic stenosis (PG/MG/AVA = 41/20/0.9) and LVEF 40-45%. Analysis of lower extremity on CT angiogram revealed adequate diameter for trans-femoral approach. The Internal Diameter of Surgical AV measured 23.1×24.6 mm (mean 23.8 mm), perimeter was 75.3mm and the area was 449.9mm2. The STS mortality risk for surgical AVR was 3.5% and logistic Euroscore mortality risk was 19.4%. The patient underwent Heart Team evaluation and was found to be at high risk for re-do SAVR due to comorbidities, advanced age and frailty. Now presents for Valve-in-Valve TAVR with 29mm Evolut-R CoreValve via left percutaneous femoral approach with Sentinel cerebral protection device.

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Mitral ViV TMVR using SAPIEN-3 Valve – May 2019
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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
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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 […]


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TAVR 29mm Sapien-3 – November 2018
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96 year old male presents with progressive exertional dyspnea (NYHA Class III) for the last 4 months.


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TAVR in a Patient with Prior Mitral Valve Replacement – September 2018
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Views 708

87 year old female presents with progressive exertional dyspnea (NYHA Class III) for the last 3 months.