SUMMARY - American Society of...
Transcript of SUMMARY - American Society of...
SUMMARY:
Clinical History Aortic stenosis PPM: MedtronicAtrial fibrillation w/AVN Ablation and PPMHypertension Sleep ApneaAAAHeart Failure
Allergy: NKDA
92 y.o. Female
STS 7.5%
NYHA Class III
Cr-1.69
Hb-13.1
PLT-152
INR-2.4
BNP-202
FEV1: N/A
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STS SCORE
STS Score
ECG
ECG•AV Paced
Medtronic PPM
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Electrocardiogram
ECHOCARDIOGRAPHY
Required MeasurementsAVA 0.47 cm2 Peak Velocity 4.23 m/s
AVA index 0.3 cm2/m2 Annulus Diameter
Mean Gradient 50 mmHg Ejection Fraction 55-60%
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Findings• Severe BAE •Severe AS• Moderate AI and TR• Mild MR •Moderate Pulmonary
hypertension
Echo findings
ECHO FINDINGS
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CAROTID ULTRASOUND
CORONARY ANGIOGRAM
CT – AORTIC ANNULUS AREA
3MENSIO
CT: Coronary Artery Distance
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LM: 16.9 mmRCA: 15.3 mm
CT: Extremities and abdomen Measurement
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LOWER EXTREMITIES VESSEL
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Right Left
PERIPHERAL SIZING- SMALLEST DIAMETERS
Minimal Luminal Diameters
Right Left
Common Iliac 7.9 mm Common Iliac 9.3 mm
External Iliac 9.5 mm External Iliac 8.6 mm
Common Femoral 8.8 mm Common Femoral 7.9 mm
Performed CT Angio on 10/2015
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PROCEDURAL PLAN:
This patient is suitable for Transfemoral
Annulus Diameter Measurement
THV Valve SizeProposed
Femoral Access SideProposed for TF Only
or TA
Smallest Vessel Diameter
Measurement
Osirix: 390mm2 23mm S3 TF 7mmEIA
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Groin Cut Downs BAV Size Bypass Size P. Pacer
Left: pigtailRight: TAVR
access
NA (moderate AI)
A: 15V: 22 NA
Allergy: Sternotomy: Yes
TEE ASSESSMENT: PRE
TEE ASSESSMENT: PRE
TEE ASSESSMENT: PRE
TEE ASSESSMENT: PRE
DEPLOYMENT OF VALVE
TEE: POST IMPLANT 3D
DISCHARGE
POD: 2 days discharged to homeEcho F/U: 30 days postClinic F/U : 30 days post