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Jay Giri, MD, MPH Massachusetts General Hospital Boston, MA

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Presentation on theme: "Jay Giri, MD, MPH Massachusetts General Hospital Boston, MA"— Presentation transcript:

1 Jay Giri, MD, MPH Massachusetts General Hospital Boston, MA
TAVR 2012 CRT Conference Jay Giri, MD, MPH Massachusetts General Hospital Boston, MA

2 Disclosures I have no relevant conflicts of interest or disclosures with regard to this presentation.

3 88 yo F: txferred for possible TAVR
Critical AS (BAV 8/2010) CAD: PTCA (remote) PVD right SFA occlusion (s/p unsuccessful PTA 2008) CVA (2010) Renal calculi (s/p right ureteral stent 1/10) HTN Hypothyroidism Chronic compression fractures of L3 and L4 Severe COPD (02 and steroid dependent) Hgt 5’8”, Wgt 64kg, BSA 1.8m², BMI 21.59kg/m²

4 Symptoms: Significant SOB at rest, presently transferred for CHF/AS NYHA: IV STS: 12.9% PARTNER Cohort: B Procedure Name Isolated AVR Risk of Mortality 12.9% Morbidity or Mortality 40.6% Long Length of Stay 31.2% Short Length of Stay 6.7% Permanent Stroke 5.7% Prolonged Ventilation 33.1% DSW Infection 0.4% Renal Failure 10.6% Reoperation 15.4%

5 Echo Results AVA = 0.61 cm² PG = 75 mmHg MG = 43 mmHg EF 25- 30%
LVOT 21 mm PASP = 48 mm Hg Mild AI/MR mild anterior MAC, severe posterior MAC, mild MS

6 Adequate TF Access

7 Coronary Angio – A Surprising Finding…

8 CTA – Confirms “Malignant” Interarterial Course

9 Will LMCA be compromised by TAVR?
BMW wire placed in distal LAD for LMCA protection Aortogram during BAV shows patent LMCA without obvious compression

10 Sapien Deployment and Post-Aortogram

11 Coronary angiography post TAVR
Swan Ganz marks RVOT Sapien Valve marks Aortic Annulus Patent LMCA runs between the two as seen in this RAO projection

12 Howard C. Herrmann, MD Wilson Szeto, MD Joseph Bavaria, MD
Acknowledgments Howard C. Herrmann, MD Wilson Szeto, MD Joseph Bavaria, MD

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