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. A transthoracic echocardiogram showed LVEF 30%, moderately dilated LV (LVIDs 4.8 cm, LVIDd 6.3 cm) with severe global hypokinesis, mildly dilated LA, and severe mitral regurgitation. A subsequent transesophageal echocardiogram (TEE) revealed a moderately dilated LV with annular dilation, partial prolapse of the posterior mitral valve leaflet with severe centrally-directed mitral regurgitation involving the A2/P2 segment and no mitral stenosis. The STS mortality risk for surgical MVR is 4.1% and the logistic Euroscore mortality risk is 13.1%. The patient underwent a Heart Team evaluation and was found to be prohibitive risk for surgical MVR due to comorbidities, advanced age and frailty. Patient is now planned for edge-to-edge mitral valve repair with MitraClip via a transfemoral venous access and transseptal puncture.
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.