TAVR with a 26mm Evolut-FX Valve in a Very Small Patient – June 2023

CASE & Plan:
67-year-old female presents with worsening chest tightness and exercise intolerance. Past medical history is significant for hypertension, dyslipidemia. A recent TTE revealed severe aortic stenosis (PG/MG/AVA: 108/68/0.83) with heavily calcified aortic valve leaflets, mild to moderate aortic regurgitation and left ventricular EF 60%. Left heart catheterization demonstrated non-obstructive CAD. CTA demonstrated severely calcified aortic valve (Calcium score 2119), aortic valve area of 378 mm2, and perimeter of 69.9 mm. Patient’s body surface area 1.57 m2. The patients STS-PROM risk for surgery is 2.3%. Following Heart Team discussion, patient was assessed to be at low risk and appropriate for both TF-TAVR and SAVR, and selected TAVR. Now is being planned for TF-TAVR via R percutaneous femoral artery access using 26mm Evolut-FX valve with Sentinel cerebral embolic protection


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