Structural heart cases
Mitral ViV TMVR using SAPIEN-3 Valve – May 2019

Views 1319

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 persistent atrial fibrillation on warfarin. A recent TEE showed degeneration of the bioprosthesis with flail leaflet and severe MR with posteriorly directed MR jet. The transmitral gradient across the bioprosthesis was 8mmHg. There was diastolic flow predominance in the right and left upper pulmonary veins consistent with severe MR. The patient was evaluated by the Heart Team and was deemed high risk (STS
mortality 10.75%) for re-op surgical mitral valve replacement due to her advanced frailty and comorbidities. The patient is now planned for a mitral ViV TMVR with a 26 mm (+3 cc) Sapien-3
valve via transfemoral approach.

comments

Leave a Reply

Your email address will not be published.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

suggestion
Suggestions
TAVR with 26mm SAPIEN-3 Ultra Valve via Right Femoral Percutaneous – January 2020
Tags: | |
Views 75

Case and Plan: 81-year-old female with hypertension, ex-smoker, and chronic diastolic heart failure now presents with progressive exertional dyspnea NYHA Class III for the past month after walking up to 1 block. She was noted to have right lower lobe subsegmental pulmonary embolism on recent CT with evidence of old DVT requiring anticoagulation. Echo revealed […]


TF-TMVR USING 29MM SAPIEN-3 VALVE – November 12 , 2019
Tags: |
Views 212

90-year-old female with HTN, CKD-3, s/p CABG, RHD with s/p bio-prosthetic MVR (31mm bovine tissue valve in 2003) for severe mitral regurgitation and LAA resection now presents with fatigue, exertional dyspnea and pedal edema. EKG showed A-fib with controlled ventricular rate. Recent TTE on 9/19/19 showed moderate to severe bioprosthetic mitral stenosis with mild MR, […]


Evolut-R CoreValve TAVR case with difficult vascular access via percutaneous femoral approach utilizing Shockwave Lithotripsy – September 2019
Tags: | |
Views 400

Case and Plan: 91-year-old female with hypertension, hypothyroid and chronic diastolic heart failure (HFpEF) presents with progressive exertional dyspnea and NYHA CCS Class III for the past few weeks. She also had a recent hospitalization at OSH for flash pulmonary edema and heart failure exacerbation requiring IV diuretics and thoracentesis. Echo revealed severe calcified aortic […]


Echo Guided Alcohol Septal Ablation (ASA) for Refractory Symptomatic HOCM – July 2019
Views 783

64 year-old morbidly obese female with known hypertrophic obstructive cardiomyopathy (HOCM), presents with progressive exertional dyspnea NYHA CCS Class III. Echo revealed severe asymmetric septal hypertrophy (ASH) with septal thickness of 21 mm and systolic anterior motion (SAM) of anterior mitral valve leaflet, high LVOT gradient, hyperdynamic LV and mild to moderate MR with severe […]