84 year old female presented with progressive dyspnea (NYHA Class III) and a decrease in exercise tolerance <1 block. Past medical history is significant for severe aortic stenosis, CAD (s/p PCI to mLAD 2017), diabetes mellitus (diet controlled), hypertension, hypercholesterolemia and chronic renal impairment. Recent echocardiogram revealed severe aortic stenosis (PG/MG/AVA 75mmHg/44mmHg/0.80cm2) and LVEF of 60%. CT angiogram revealed left lower extremity had minimal diameter > 6mm but the right lower extremity artery access was < 6mm. The aortic annulus measured 18x26mm (average 22mm) and the annular area was 376mm2 and perimeter of 70.9mm. STS mortality risk for surgical AVR was 4.3% and the logistic Euroscore mortality risk was 10.1%. Patient underwent Heart Team evaluation and was found to be at prohibitive risk for SAVR due to porcelain aorta. Now presents for TAVR with 23mm Edwards Sapien-3 valve via the left percutaneous femoral approach.
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.