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CASE 01: Simultaneous Tavi and Mitral ViV Procedures-Dr.Georg NICKENIG -Dr.Grube EBERHARD- Dr.Nikos WERNER

This   procedure concerns a 74 years old female , with medical history of CABG and mitral valve replacement, Atrial fibrillation,Chronic Kidney disease on hemodialysis, also COPD II

Presenting   Heart failure III NYHA  with severe aortic stenosis and degenerated mitral bioprosthesis.

Strategy Plan

Imaging studies

  • Echo: LVEF:68%,Moderate MS : MG:9mmhg , 1,4cm²(PHT), Severe low flow low gradient AS : AVA:0.7cm² , MG:25mmhg, SVi:28ml:m², ARII: PHT:300ms ,LVEDD:42mm 
  • Coronary angiography: Two vessels disease.
  • Cardiac CT: AV:Area :370mm², Primeter:37.3mm,calculated Neo-LVOT:227mm² ; MV:CE perimount 27mm(real ID:25mm), Area:430mm²

Clinical indication

  • Severe  aortic stenosis with degenerated mitral bioprosthesis ( Log EUROSCORE:48.42% , STS Score:19,8%).
  • Heart Team decision 

Planned Procedure

  • Transfemoral TAVI with Evolut Pro 29mm
  •  Mitral ViV with Edwards Sapien 3 (26mm)

CASE 02: Left Circumflexe aneuvrysm   -Dr.Georg NICKENIG -Dr.Grube EBERHARD- Dr.Nikos WERNER

 80 years old male , medical history CAD with RCA stenting (2018) , presenting stable angina III and Lcx aneuvrysm.

Strategy Plan

Imaging studies

  • Echo: preserved LVEF, 
  • Coronary angiography: Lcx aneuvrysm
  • Cardiac CT: 3D pattern and modelling 

Clinical indication

  • stable angina

Planned Procedure

  • Aneuvrysm exclusion using coils and regularDES implantation.
Shooting date : 2018-02-23
Last update : 2018-08-08

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