Same session MitraClip system for Mitral and Tricupid regurgitations - Complex RCA ostial CTO - Complex TAVI in pure Aortic regurgitation

CASE 01: Simultaneous Re-MitraClip for functional Mitral Regurgitation & MitraClip for Tricuspid regurgitation  -Dr.Georg NICKENIG  - Dr.Nikos WERNER

Strategy Plan

Imaging studies

• Coronary angiography: 2 vessels CAD
• Echo:  LV EF  41%, moderate to severe mitral regurgitation,severe Tricuspid regurgitation.
• Nuclear testing :postive ischemia and viability 

Clinical indication

• Heart failure  III NYHA   (Log EUROSCORE:20.1% - STS SCORE:12.1%) 
• Heart Team decision

Planned Procedure

• Edge-To-Edge mitral regurgitation  repair with MitraClip system.
• Same session Edge-to-Edge tricuspid repair with MitraClip system.

CASE 02: Complex Retrograde RCA ostial CTO PCI  -Dr.Paul Hsien-Li Kao  - Dr.Nicos WEINSTEIN

Strategy Plan

Imaging studies

• 3 vessels disease, LAD and Lcx patent 
• Echo:  LV EF  40%, inferior hypokinesia
• Stressecho testing :postive i

Clinical indication

• Heart failure III NYHA   
• Positive viability

Planned Procedure

• Retrograd attempts first startegy.

CASE 03: Transfemoral TAVI in Pure Aortic regurgitation -Dr.Grube EBERHARD  - Dr.Nikos WERNER

Strategy Plan

Imaging studies

• Echo:  LV EF  56%, Severe aortic regurgitation, moderate to severe  mitral regurgitation,LEDD:74mm
• CT scann : area 520mm² , perimeter:82.7mm , annulus: 24.X28.5mm

Clinical indication

• Severe aortic regurgitation   (Log EUROSCORE:1.51% - STS SCORE:1.45%) 
• Heart Team decision

Planned Procedure

• Transfemoral TAVI with 34mm Evolut-R