74-year-old male presents with progressive dyspnea NYHA class III over the last 6 months. Past medical history of severe AS s/p valve sparing aortic root replacement with 30mm Valsalva graft on 6/24/2015 for ascending aortic aneurysm, Diabetes Mellitus, Hypertention, Hyperlipidemia, Hepatitis C, Right Leg deep venous thrombosis on Eliquis, and OSA. A recent TTE (8/10/26) showed severe aortic stenosis (PG/MG/PV/AVA: 83/43/4.5/0.6), mild AR, PFO, Mild-Mod MR with LVEF 60%. Patient was evaluated by the Heart Team and was deemed high risk for SAVR in view of age and co-morbidities. CTA showed aortic annulus of 26.6 x 29.5 (Avg 28mm), annular area of 630.4 mm2 and perimeter of 89.5 mm. Hence, the patient is now planned for a TAVR with a 29mm SAPIEN-3 Ultra Resilia valve post valve-sparing aortic root replacement via right transfemoral approach.
