Structural heart cases
Valve-in-Valve TAVR with 29mm Evolut-R CoreValve – January 2019

Views 1360

79 year old man presents with progressive exertional dyspnea (NYHA Class III) for the last 2 months. Past medical history is significant for CABG (SVG to D1 and SVG to RPL) & bioprosthetic surgical AVR (25mm Perimount 2700) in 03/09/04, atrial flutter s/p ablation, hypertension and hyperlipidemia. Recent echocardiogram revealed severe bioprosthetic aortic regurgitation due to leaflet degeneration and coaptation gap, moderate prosthetic aortic stenosis (PG/MG/AVA = 41/20/0.9) and LVEF 40-45%. Analysis of lower extremity on CT angiogram revealed adequate diameter for trans-femoral approach. The Internal Diameter of Surgical AV measured 23.1×24.6 mm (mean 23.8 mm), perimeter was 75.3mm and the area was 449.9mm2. The STS mortality risk for surgical AVR was 3.5% and logistic Euroscore mortality risk was 19.4%. The patient underwent Heart Team evaluation and was found to be at high risk for re-do SAVR due to comorbidities, advanced age and frailty. Now presents for Valve-in-Valve TAVR with 29mm Evolut-R CoreValve via left percutaneous femoral approach with Sentinel cerebral protection device.

50:31

comments

Join the Discussion

2 thoughts on “Valve-in-Valve TAVR with 29mm Evolut-R CoreValve – January 2019”

  1. Diane Calabrese says:

    I absolutely LOVE watching these cases and share them with all of my colleagues !
    I always learn so much !
    Thank you Drs. Kini & Sharma ….you rock !

  2. sas says:

    Fantastic case! However the the case ppt doesnt correspond to the presentation. Would be great to have Drs Kini & Sharmas ppt from the case!

    regards


Leave a Reply

Your email address will not be published. Required fields are marked *


By submitting this form, you are consenting to receive marketing emails from: Mount Sinai Hospital, One Gustave L. Levy Place, Box, New York, NY, 10029, https://ccclivecases.org. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact

suggestion
Suggestions
Bioprosthetic Aortic ViV TAVR after Valve Fracture and Evolut Pro+ Implantation – November 2020
Views 72

  Case and Plan: 60 year-old male presents with worsening exertional dyspnea (NYHA Class III) and multiple admissions for CHF exacerbation in past 3 months. Past medical history is significant for symptomatic severe aortic insufficiency s/p bioprosthetic AVR (2017) with 23mm Magna 3000 valve, ESRD on HD, HTN and HLD. Recent echocardiogram revealed bioprosthetic valve […]


TF-TAVR with No Contrast – September 2020
Views 182

Case and Plan: 61 year-old-male with ETOH abuse, hepatitis and cirrhosis s/p Liver transplant in 6/2019 at MSH with postop course notable for AKI requiring dialysis (last dialysis 7/6/2019), Hypertension, Anemia, Former smoker, CKD stage III.


59:42
Urgent Appropriately Indicated MitraClip Procedure in Patient with Cardiogenic Shock in Covid-19 Era – May 2020
Views 896

 Case and Plan: 74-year-old male former smoker with PMHx of HTN, HLD, and A Fib (on Eliquis) had IW-STEMI on 02/09/20. Cath showed occluded mRCA with dLM bifurcation disease; S/p DES-PPCI to mRCA. Transthoracic echocardiogram at the time of discharge showed an EF of 55% with moderate MR. Pt had staged PCI to dLM […]


TAVR using Transcarotid Access – March 2020
Tags: |
Views 727

Case and Plan: 73-year-old male with hypertension, hyperlipidemia, parathyroidectomy, renal cell carcinoma s/p nephrectomy and right renal transplant in 2001 on chronic steroids and immunosuppressant therapy, paroxysmal atrial fibrillation on AC with warfarin, chronic diastolic heart failure and severe PAD presents with progressive exertional dyspnea NYHA-Class III for the past month after walking up to […]