Case and Plan
74-year-old male presents with acute dyspnea, NYHA class III. Past medical history is significant for bicuspid aortic stenosis and aortic root dilatation s/p 29mm Perimount 2700 valve and aortic replacement with 30mm Hemashield graft in 2013, hypertension, and kyphoscoliosis. TEE showed LVEF 60% with severe eccentric AI from flail leaflet of bioprosthetic valve. The heart team found the patient at high risk for redo surgical AVR and recommended VIV TAVR. Now planned for VIV TAVR via right percutaneous femoral access using a 29mm Sapien-3 Ultra Resilia valve and Sentinel embolic protection.
