96 year old male presents with progressive exertional dyspnea (NYHA Class III) for the last 4 months. Past medical history is significant for severe aortic stenosis (AS), non-obstructive CAD, hypertension, hyperlipidemia, diabetes, atrial fibrillation on anticoagulation and prostate cancer in remission. Recent echocardiogram revealed severe calcific aortic stenosis (PG/MG/AVA = 29/16/0.7) and LVEF 53% with stroke volume index of 27.6 ml/m2 low flow-low gradient paradoxical severe AS (LF-LG AS). Analysis of lower extremity on CT angiogram revealed adequate diameter for trans-femoral approach. The aortic annulus measured 27.5 x 33.5 mm (mean 30.5 mm), annular perimeter was 95.5 mm and the annular area was 713.4 mm2. The STS mortality risk for surgical AVR was 12.0% and logistic Euroscore mortality risk was 37.09%. The patient underwent Heart Team evaluation and was found to be at extreme risk for SAVR due to advanced age and frailty. Now presents for TAVR with a 29 mm (+2cc) SAPIEN-3 via 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.
TAVR in a Patient with Prior Mitral Valve Replacement – September 2018
87 year old female presents with progressive exertional dyspnea (NYHA Class III) for the last 3 months.