Case and Plan:
89-year-old female presents with progressive dyspnea NYHA class III over the last 6 months and frailty. Past medical history of hypertension, hyperlipidemia, hypothyroidism, GERD, and anxiety. A recent TTE showed severe aortic stenosis (PG/MG/PV/AVA; 67/37/4.1/0.72) and LVEF 65%. Patient was evaluated by the Heart Team and was deemed extreme risk for SAVR in view of age and frailty. CTA showed small aortic annulus of 17.2 x 25.5 (Avg 21.4mm), annular area of 355.6mm2 and perimeter of 68.8mm. Bilateral iliacs had significant tortuosity and significant stenosis of right common iliac artery. Hence, the patient is now planned for a TAVR with a 26mm Evolut Fx+ valve via left transfemoral approach.
