| Paper 1 | |
|---|---|
| Patient Name | Fathya Mahmoud Mohamed |
| Age | 68 |
| Clinical evaluation | |
| Consultation date | 10/14/2024 |
| Previous assessment for TAVI | yes |
| History and risk factors | |
| Prior CABG | no |
| Prior aortic valve procedure | no |
| Prior other valve procedure | no |
| Number of previous cardiac surgery | none |
| Prior arrhythmia | no |
| Permanent peacemaker | no |
| Other history | |
| Previous CVA or TIA | no |
| Extracardiac arteriopathy | no |
| Hypertension | yes |
| Diabetes melitus | yes |
| Renal insufficiency requiring dialysis | no |
| Renal insufficiency requiring renal transplant | no |
| Chronic lung disease | no |
| Malignancy (prior or current) | no |
| Paper 2 | |
| Clinical evaluation continued | |
| Syncope | no |
| CCS | yes |
| NYHA | I |
| Clinical data | |
| Height (cm) | 166 |
| Weight (kg) | 80 |
| Body mass index (BMI) | 27.4 |
| Hemoglobin (g/dl) | 11.3 |
| Creatinine (mg/dl) | 0.9 |
| Creatinine clearance | 77 |
| Pre-operative special investigations | |
| ECG | |
| Rhythm | Regular |
| PR Interval (ms) | 130 |
| QRS Duration (ms) | 85 |
| ECHO (TTE or TOE) | |
| Mean gradient across aortic valve (mm Hg) | 45 |
| Aortic valve area (cm2) | 0.9 |
| Ejection fraction (%) | 66 |
| Associated valvular lesions | |
| Aortic insufficiency | mild |
| Mitral insufficiency | none |
| Mitral stenosis | none |
| Tricuspid insufficiency | none |
| Tricuspid stenosis | none |
| Pulmonary insufficiency | none |
| Pulmonary stenosis | none |
| Paper 3 | |
| TAVI evaluation | |
| Risk profile | |
| Predicted operative risk | Intermediate |
| STS score (%) | 1.69 |
| Euroscore II (%) | 1.32 |
| Contra-indication to surgery | no |
| Reason for contra-indication to surgery | |
| Frailty | no |
| Porcelain aorta | no |
| Patent LIMA graft | no |
| Hostile thorax | no |
| Further investigations | |
| Lung function tests | no |
| Angiogram | no |
| Number of diseased vessels | 2 |
| PCI or revascularization indicated | yes |
| CT coronary angiogram | yes |
| Pre TAVI CT Assessment | |
| Aortic Annulus | |
| Perimeter (mm) | 64.2 |
| Perimeter derived (mm) | 20.3 |
| AREA (mm2) | 331.3 |
| Area derived (mm) | 20.4 |
| LVOT | |
| Perimeter (mm) | 65.4 |
| Perimeter derived (mm) | 22.6 |
| AREA (mm2) | 352 |
| Area derived (mm) | 24.7 |
| Sinus of Valsalva | |
| Left | 27 |
| Right | 26 |
| Non | 27 |
| MAX Ascending Aorta Angle | 28.7 |
| STJ Angle | 22.7 |
| Measurements | |
| Aortic Annulus | |
| Min Aortic Annulus Diameter (mm) | 19.8 |
| Max Aortic Annulus Diameter (mm) | 21.3 |
| Average Aortic Annulus Diameter | 20.3 |
| LVOT | |
| Min LVOT diameter | 16.3 |
| Max LVOT diameter | 23.8 |
| Average Aortic Annulus Diameter | 20.3 |
| STJ angle | |
| Min | 22.3 |
| Max | 23.6 |
| Average | 22.5 |
| LCA Height | 12.3 |
| RCA Height | 16.5 |
| Aortic Valve Calcification | Severe |
| Aortic Root Angulation | 50 |
| Paper 4 | |
| TAVI procedure | |
| Procedure date | 10/14/2024 |
| Type of anesthesia | local |
| TOE used intra-operatively | no |
| Valve in valve procedure | no |
| Procedural success | yes |
| Reason procedural not successful | Patient died due to retropritoneal hematoma |
| Procedural complications (VARC < 72 hours) | |
| Intra-procedural mortality | no |
| Consequent mortality < 72 hr post-procedure | yes |
| Myocardial infarction | no |
| Stroke or TIA | no |
| New PML | no |
| Bleeding complications | yes |
| Vascular complication | yes |
| Valve dysfunction | no |
| Other thrombotic or embolic complications | no |
| Cardiopulmonary bypass required | no |
| Other procedural complications | no |
| Conversion to open heart surgery | no |
| Device information | |
| Number of valves implanted | 1 |
| Valve 1 | |
| Type implanted | Boston |
| Medtronic data | |
| Boston data | |
| Model implanted | ACURATE neo2 |
| Size implanted | L |
| Valve result | not-detectable |
| Hospital stay | |
| Days in ICU | 2 |
| Paper 5 | |
| Follow up information | |
| General follow up | |
| Stroke / TIA since TAVI | no |
| PPM since TAVI | no |
| Hospital admission | no |
| Follow up 30 days | |
| Stroke / TIA since TAVI | no |
| PPM since TAVI | no |