Case and Plan:
89-year-old male with history of HTN, HLD, subarachnoid hemorrhage and stroke (2020) without residual deficits and CAD s/p 4 vessel CABG in 2018. Now presents with progressive shortness of breath, intermittent chest pain and dizziness for the past 6-8 weeks. Recent transthoracic echocardiogram demonstrated LVEF of 75%, mild MR, calcified aortic valve, severe stenosis (PG/MG/PV/AVA: 93/60/4.82/0.63), SVI 34.5 ml/m2 and mild AR. Pre-procedural CTA demonstrated aortic valve calcium score of 2070, mean aortic annulus diameter of 23.1 mm, annular perimeter of 72.5 mm and annular area 402.8 mm2. His STS PROM score for SAVR was 4.19% and Heart Team evaluation found him to be high surgical risk. He is planned for transfemoral TAVR via left percutaneous femoral arterial access using a 27 mm NAVITOR Vision valve.
