Valvular Heart Disease - School of MedicineValvular Heart Disease Ihab Alomari, MD, FACC Assistant Professor of Medicine Associate Director, Interventional Cardiology Fellowship Division

Valvular Heart Disease

Ihab Alomari, MD, FACC Assistant Professor of Medicine Associate Director, Interventional Cardiology Fellowship Division of Cardiovascular Diseases University of California -Irvine

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Disclosure

Nothing to disclose

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Background

Cardiology, 01, 2019

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Dismal Outcomes of Severe Inoperable AS

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How it looks post-intervention

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Core Valve system

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Core Valve Specifics

Nitinol self expanding frame • One frame with three different diameters and radial/hoop

strengths. Porcine Pericardial Tissue • Leaflets and skirt elements

– Fixation and sterilization • Valve 26 mm, 29 mm, 31 mm • Partially repositionable

Study started in the U.S. in 2010.

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How CoreValve looks post-intervention

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PARTNER Inclusion Criteria

Severe AS: Echo-derived AVA < 0.8 cm2 (or AVA index < 0.5 cm2/m2) and mean AVG > 40 mm Hg or peak jet velocity > 4.0 m/s

Cardiac Symptoms: NYHA Functional Class ≥ II

High surgical risk: Predicted risk of operative mortality ≥ 15% (determined by site surgeon and cardiologist); STS score ≥ 10

Inoperable patients: Predicted risk of 30 day mortality ≥ 50% post-surgery or a serious irreversible condition. • ≥ 2 surgeons agreement that patient is inoperable.

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Cohort B (inoperable)

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Cohort B (inoperable)

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Cohort B (inoperable)

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Cohort B (inoperable)

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Mitral Clip

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Mitral Clip

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What is Next ??

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Thank you

Department Name | Month X, 201X