CoreValve Evolut-R TAVR (26mm) via Percutaneous Femoral Access – April 2016

An 83 year-old female presented with worsening dyspnea on exertion– NYHA class III and fatigue, with a history of hypertension, Atrial Flutter s/p PPM, moderate COPD, Septal Hypertrophy s/p ablation, kyphosis, and Rt. Breast CA s/p radiation. TTE revealed severe AS, peak/mean aortic gradient = 79/49 mmHg, AVA = 0.5 sq cm, aortic peak velocity = 4.4 m/sec and LVEF 57%. CT angio showed minimum diameters of 0.8 x 0.9 cm for right and 0.8 x 0.9 cm for left common femoral arteries and aortic annulus of 2.4 X 1.8 cm (average 2.1 cm). The STS risk mortality is 5.8% and the Logistic Euroscore mortality is 14.7%. Patient was determined to be high risk for surgical AVR due to COPD and frailty. Patient is now planned for Evolut-R CoreValve TAVR (26mm) via percutaneous femoral access under conscious sedation.

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