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.
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.