STRUCTURAL HEART
26mm Evolut-PRO CoreValve TAVR – March 2018

94 year old female presented with progressive dyspnea (NYHA Class III) and lower extremity edema. Past medical history is significant for severe aortic stenosis, CAD (s/p PCI to pLAD and D1 on 01/09/2018), hypertension, hypercholesterolemia and chronic atrial fibrillation (on rivaroxaban). Recent echocardiogram revealed paradoxical low flow low gradient severe aortic stenosis (PG/MG/AVA 35mmHg/25mmHg/0.6cm2) with dimensionless index (DI) = 0.22 and LVEF of 60%. Analysis of lower extremities on CT angiogram revealed adequate diameter for trans-femoral approach. The aortic annulus measured 19.8×24.8mm (average 22.3 mm) and the annular area was 386mm2 and perimeter of 70.7mm. STS mortality risk for surgical AVR was 9.5% and the logistic Euroscore mortality risk was 45%. Patient underwent Heart Team evaluation and was found to be at high risk for SAVR due to comorbidities, advanced age and frality. Now presents for TAVR with 26mm Evolut-PRO CoreValve via the right percutaneous femoral approach with sentinel cerebral protection device.

46:41

comments

Leave Your Comments

Your email address will not be published. Required fields are marked *

*

suggestion
Suggestions
Valve-in-Valve TAVR with 29mm Evolut-R CoreValve – January 2019
Views265

79 year old man presents with progressive exertional dyspnea (NYHA Class III) for the last 2 months.


TAVR 29mm Sapien-3 – November 2018
Tags:
Views503

96 year old male presents with progressive exertional dyspnea (NYHA Class III) for the last 4 months.


TAVR in a Patient with Prior Mitral Valve Replacement – September 2018
Tags: |
Views537

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


Edge-to-Edge Mitral Valve Repair with MitraClip – July 2018
Tags: | |
Views653

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.