11 Dec 2025
TAVI in small annulus - LIVE Case
TAVI in small annulus with self expandale valve without pre and post dilatation
Summary
A 65-year-old female with obesity, diabetes mellitus, a history of stroke, atrial fibrillation, and RBBB on ECG, presented with symptomatic aortic stenosis and two-vessel coronary disease (OM and LAD, QFR: 0.70). Echocardiography and CT showed normal LV function (55%), a small annulus (370 mm²), and a borderline left coronary height (10 mm).
The OM was treated by PCI, and the LAD FFR was negative. The TAVI procedure was staged. A 26 mm Evolut FX+ valve was implanted using a cups-overlap view with commissural alignment on pacing (140 bpm), without pre- or post-dilatation. Left main patency was confirmed after the procedure.
LIVE Educational Case from King Faisal Cardiac Center, National Guard Health Affairs- Western region - Jeddah, Saudi Arabia
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Key moments
- 27:05–37:50 – Valve implantation with commissural alignment
- 57:28–1:01:06 – Vascular closure (2 ProStyles)
Keywords: Aortic stenosis, Evolut FX+, Vascular closure
