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An 81-year-old patient with complex high-risk cardiac problems successfully underwent Transcatheter Aortic Valve Implantation/Replacement.

09 Jul 2018

An 81 year old Patient , who was denied for Surgical Aortic valve at 3 hospitals and TAVR by another hospital being very high-risk case (STS score-Risk of Mortality 10.6 %, Risk of Morbidity 42.9%) was successfully operated at Apollo Hospitals, Chennai.

Patient was having double whammy of CAD and Severe Aortic stenos (AS); the CAD was in the form of old anterior wall Myocardial Infarction. Patient had previously undergone PCI to LAD, Diagonal and OM with occluded RCA. AS was complicated by severe biventricular dysfunction (LVEF 20%), severe PAH and low cardiac output. Due to heart failure, Patient was frequently getting hospitalized at different Centres.

Dr. Y Vijayachandra Reddy, Senior Consultant & Interventional Cardiologist, Dr. G. Shyam Kumar, Dr. Sai Satish, Dr. Ganapathy with backup team of Dr. M Caskey and Dr. L F Sridhar along with our Cath Lab team performed "Transcatheter Aortic Valve Implantation/ Replacement (TAVR)" on this complex high-risk cardiac patient. Under general anesthesia, a facile totally percutaneous procedure of "big-valve (34 mm Evolut-R) TAVR", with precise positioning of the valve, gave an exceptionally good result without any need for permanent pacemaker.

Apollo Hospitals, Chennai once again proved 'Centre of Excellence' by handling such a 'High-Risk' case which many other hospitals denied. By having the nightmare turned into a promising dream, patient was discharged with satisfaction.