Cases in Interventional Cardiovascular Medicine: Read & Share cases

A frail patient presents with worsening NYHA class III dyspnoea and peripheral oedema despite optimal medical therapy. Previously managed conservatively, severe tricuspid regurgitation has progressed to a torrential grade, with right-sided chamber dilatation and complex valve anatomy.

How would you treat this patient?

This 77-year-old woman with paroxysmal AF and prior GI bleeding is referred for LAA closure, but CT reveals a shallow, inferior chicken-wing morphology that complicates device selection and planning. How would your Heart Team approach this challenging case?

A 79-year-old patient previously treated with surgical aortic valve replacement was referred after an episode of acute cardiac decompensation. Although clinically stabilised, further evaluation revealed degeneration of the bioprosthesis, and mixed aortic valve pathology.

This case focuses on the diagnostic assessment and the strategic considerations guiding the...

Managing mixed mitral valve disease is particularly challenging in patients with prior chest irradiation and extensive calcification.

A 40-year-old man presents with severe symptomatic MR, renal impairment, and an unusual eggshell-like left atrium. Imaging reveals complex mitral anatomy and critical constraints for transcatheter therapy.

How would you approach...

A 78-year-old male presents with recurrent HFpEF hospitalisations and severe degenerative MR. Multimodality imaging reveals fibro-calcific leaflet disease, restricted motion, and a short posterior leaflet, making him a suboptimal candidate for M-TEER and prompting consideration of transcatheter mitral valve replacement. How would you treat?

An 83-year-old female patient with HFrEF due to NICM and a history of arterial hypertension and persistent atrial fibrillation was referred with worsening exertional dyspnea, severe functional mitral regurgitation and moderate tricuspid regurgitation.

How would you treat this patient?

A 79-year-old woman with advanced right heart failure (NYHA III) was referred after repeated hospitalisations for decompensation despite optimal medical therapy. Echocardiography revealed torrential functional tricuspid regurgitation with suitable anatomy for T-TEER. Given her high surgical risk (TRISCORE 7/12) and borderline pulmonary hypertension, how would you...

An 85-year-old woman presents with exertional dyspnea and angina, alongside severe paradoxical low-flow, low-gradient aortic stenosis, marked mitral and tricuspid valve disease, and two-vessel coronary artery disease. Frailty markers and hostile pelvic anatomy further complicate her profile.

How would your Heart Team approach this challenging case?

An 81-year-old man with history of severe aortic stenosis previously treated with a balloon-expandable transcatheter valve was referred for progressive exertional dyspnea due to bioprosthetic valve degeneration.

How would you treat this patient?

In this challenging redo TAVI case, an 87-year-old woman presented with severe bioprosthetic valve restenosis and advanced heart failure symptoms, eight years after a previous transapical implantation.

Her frailty, prior surgical approach, and complex anatomy—with low coronary heights and a stent frame extending beyond the sinotubular junction—posed...