Ontology highlight
ABSTRACT: Rationale
In super-aged patients with severe symptomatic aortic stenosis, transcatheter aortic valve replacement (TAVR) is a good treatment option, and the number of TAVR-eligible elderly patients is expected to grow exponentially. We present the case of a nonagenarian woman with severe aortic stenosis who underwent successful subclavian TAVR.Patient concerns
A 90-year-old Korean woman was brought to our department with dyspnea. On physical examination, a grade IV systolic murmur was auscultated in both the upper sternal borders and the left lower sternal border.Diagnosis
A transthoracic echocardiogram showed heavy calcification of the aortic valve with an increase in both peak velocity (4.36 m/s) and mean pressure (44.8 mm Hg), indicating severe symptomatic aortic stenosis.Interventions
After a heart team conference involving interventional cardiologists, cardiac surgeons, and anesthesiologists, subclavian TAVR was performed. Using the left subclavian artery, we successfully deployed a self-expandable valve prosthesis (CoreValveTM Evolut RTM, Medtronic Inc., Minneapolis, MN).Outcomes
After TAVR, transthoracic echocardiogram showed a decline in both peak velocity (2.06-2.14 m/s) and mean pressure (7.42-7.95 mm Hg) with an increase in the aortic valve area (1.12 cm2). The patient's dyspnea symptoms improved dramatically.Lessons
In addition to femoral TAVR, subclavian TAVR may be feasible and safe in super-aged patients.
SUBMITTER: Oh S
PROVIDER: S-EPMC8797506 | biostudies-literature | 2022 Jan
REPOSITORIES: biostudies-literature
Oh Seok S Kim Ju Han JH Hyun Dae Young DY Cho Kyung Hoon KH Kim Min Chul MC Sim Doo Sun DS Hong Young Joon YJ Ahn Youngkeun Y Jeong Myung Ho MH Jung Yochun Y Lee Kyo Sun KS
Medicine 20220101 4
<h4>Rationale</h4>In super-aged patients with severe symptomatic aortic stenosis, transcatheter aortic valve replacement (TAVR) is a good treatment option, and the number of TAVR-eligible elderly patients is expected to grow exponentially. We present the case of a nonagenarian woman with severe aortic stenosis who underwent successful subclavian TAVR.<h4>Patient concerns</h4>A 90-year-old Korean woman was brought to our department with dyspnea. On physical examination, a grade IV systolic murmur ...[more]