Case and Plan:
75-year-old male presents with worsening NYHA Class III symptoms of heart failure for the last 3 months. Past medical history is significant for CAD, Prior PCI, s/p CABG 2012 (LIMA to LAD, SVG to OM1 and occluded SVG to RPDA), HTN, HLP, DM, H/o TIA and mild Parkinson’s disease. Recent echocardiogram revealed LVEF of 67%, mild TR/MR, Severe valvular aortic stenosis (PG/MG/AVA/PV: 53/33/0.9/3.65). His STS PROM risk for AVR was calculated at 3.5%. Heart Team evaluation found him to be appropriate for TAVR. Now planned for trans-femoral TAVR via right percutaneous femoral arterial access using a 23mm Sapien-3 Ultra valve with Sentinel cerebral embolic protection device.