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.
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.