TAVI With Most Advanced Self- Expanding Valve

About the Patient

A senior retired Medical Practitioner was diagnosed as a case of “Severe Symptomatic Aortic Stenosis – NYHA CLIl”. During evaluation his blood chemistry was normal, ECG showed LVH; 2D Echo confirmed severe Aortic Stenosis (PSG 88 mmHg + mean gradient 50 mmHg with normal LVEF). He was advised Coronary Angiography + Surgical Aortic Valve Replacement(SAVR). However, patient refused to undergo SAVR with a negative written consent. He opted for a Transcatheter Aortic Valve Implantation (TAVI) procedure.

Case Scenario

With no comorbidities and fair GC, he was low risk for SAVR. Angiography showed distal LAD CTO and moderate mid RCA plaque. His TAVI was performed on 1 Dec 2023 via transfemoral route under mild sedation by Dr(Col) Ajay Bahadur, Dr K K Sahni & Cardiac Sciences team with support of Cardiac Anaesthesia.

Team led by Dr S Sarkar & surgical back up by Dr Bharat Dubey,CTVS at Apollomedics Super Speciality Hospitals, Lucknow.

World-wide Scenario

At our center we have used balloon expandable Valves for TAVI, but in this case, TAVI was done with most advanced State of the Art Self-expanding Valve Evolut Pro Plus – Medtronics. This is safer with better results..

Expertise at Apollomedics Hospital, Lucknow

The procedure was successful. Patient had transient Left bundle-branch block which reverted to Normal Sinus Rhythm over next 24 hours. The post-op Echo showed no residual gradient across the Valve. The patient was discharged successfully on 2nd Post-op day and remains asymptomatic during follow up.

Case Managed by

Dr(Col) Ajay Bahadur & Team

Sr Consultant Interventional Cardiology

Apollo Hospitals, Lucknow