A 89 year-old male presented with worsening dyspnea on exertion– NYHA class III and fatigue, with history of hypertension, hyperlipidemia and multiple prior PCIs. Patient also suffers from mild cognitive impairment as a result of childhood meningitis. TTE revealed severe valvular aortic stenosis; peak gradient = 88 mmHg, mean gradient = 58 mmHg, Doppler valve area = 0.66cm2, Ao peak velocity = 4.7m/sec and LVEF of 63 %. Cardiac cath showed non-obstructive CAD with patent stents. CT angiogram revealed minimum diameters of 10.5mm for bilateral common iliac arteries and aortic annulus of 25.2 X 21.3 mm (average 23.2mm) with an area of 410mm2. The STS mortality risk for Surgical AVR is 1.5% and the Logistic Euroscore mortality risk is 11.3%. Patient was determined to be intermediate risk for SAVR due to age and neurological dysfunction and is now planned for TAVR with Edwards Sapien 3 (23 mm) valve via percutaneous femoral access under conscious sedation.
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.