79 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 in 2008), diabetes mellitus, hypertension, hypercholesterolemia, pulmonary hypertension, hepatitis C, non-hodgkins lymphoma, hypothyroidism, DJD spine and GERD . Recent echocardiogram revealed progression to severe aortic stenosis (PG/MG/AVA 74mmHg/50mmHg/0.57cm2) and LVEF of 58%. CT angiogram revealed bilateral lower extremity and left upper extremity arterial access had minimal diameter < 6mm but the right upper extremity artery access >6mm. The aortic annulus measured 21x26mm (average 23.6mm) and the annular perimeter was 76mm. STS mortality risk for surgical AVR was 3.6% and the logistic Euroscore mortality risk was 8.9%. Patient underwent surgical evaluation and was found to be at high risk for SAVR. Now presents for TAVR with 29mm Evolut-R CoreValve via the right subclavian artery cutdown.
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.