88 year old female presented with chest pain and progressive dyspnea on exertion (NYHA Class III). Past medial history is significant for hypertension, hyperlipidemia, DM, AF on Coumadin, PPM, CABG, Colorectal Carcinoma, Anemia and OSA. TTE revealed severe aortic stenosis (peak gradient = 68 mmHg, mean gradient = 42 mmHg, Doppler valve area = 0.64 cm2, Aortic peak velocity = 4.13m/sec) and LVEF of 62 %. Coronary angiogram showed II Vessel CAD and patent grafts. CT angiogram revealed minimum diameters of ≥ 6.5 mm for bilateral common iliac arteries and aortic annulus of 21 X 26 mm (average 23.5 mm) with an annular circumference of 75 mm and perimeter derived diameter of 24mm. Coronary ostial height was 16 mm on left and 15 mm on the right. The STS mortality risk is 13.86 % and the Logistic Euroscore mortality risk is 49.15%. Patient was determined to be at extreme risk for SAVR due to co-morbidities. Pt is now planned for transfemoral TAVR with EVOLUT-R (29 mm) via percutaneous femoral access under conscious sedation.
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.