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Courtesy of Dr. T Lefèvre, Dr. M-C Morice, Dr. B Cormier, ICPS, Massy - France
Patient History
This is a case of a 85 year-old female patient, presenting an Euroscore of 37%.
She suffers from cardiac insufficiency and is referred for a percutaneous valve replacement.
Procedure
For the aortic valve anatomy understanding, an Innova 3D Cardiac acquisition is performed on Innova 2100IQ.
After the beginning of the right ventricular rapid pacing at 200 bpm, 70 ml of contrast media is injected at the flow rate of 14 ml/s.
The 2D projections are sent to the Advantage Workstation and the 3D Volume is automatically reconstructed.
The Volume Rendering and 3D MIP depict clearly the valve anatomy and help to select the angulations of the working views.
Oblique cross-sections parallel and perpendicular to valve plane are simultaneously displayed. This allows measurements of the distance to the coronary ostia and the annulus diameter, confirming a size of 21 to 22 mm.
After the placement of an Extra Support guide at the apex, a 23 mm percutaneous Cribier Edwards prosthesis (Edwards Lifesciences, Irvine, CA, USA) is successfully positioned by dilating a 23 mm ZIMED balloon (NuMED, Inc., Hopkinton, NY, USA).
A remaining aortic regurgitation of 2-3 /4 is corrected by post-dilation, allowing to moderate it at 2/4.
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