Aortic ViV (Trifecta #21)

A 79yo woman who underwent AVR 5 years ago (Trifecta #21) was admitted with a complete loss of consciousness event and head injuries, and reported exertional dyspnea in the prior months.  Echocardiography showed severe stenosis of the bioprosthetic valve with Vmax 5m/s, AVA 0.7cm², LVEF 60% and PASP 35mmHg. There was prior history of COAD and mild CRF. EuroSCOREII was calculated 8%, STS 9% and STS m&m 20%. The Heart Team decision was to treat her with ViV TAVI.