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About a very severe Stenosis

EACVI Valvular Imaging Box

Author : Dr. Erwan Donal.

Cardiology Services of RENNES's CHU

Contact : erwan.donal@chu-rennes.fr


 

Description

  • Asymptomatic 65 year old lady
  • She has just been discovered a breast cancer
  • She’s supposed to get chemotherapy and surgery

Clinical case information

 

 

 

  • LV EF 60%
  • Mild Mitral Regurgitation
  • Normal Right heart


Very calcified Aortic Valve

 



 

  • LVOT vti = 11.5 cm
  • Stroke Volume = 29 ml/m² ( less than 35ml/m2)
  • LVOT diameter 23 mm
  • Aortic Valve : Vmax = 6.2 m/s (> 5.5 m/s) :
    • Mean Pressure Gradient = 95.6 mm Hg
    • Effective orifice Valve area = 0.35 cm²

 

 



 



 



 

  • Mild to moderate functional MR linked to the severity of the Ao S
  • No organic abnormality of the mitral valve
  • Tricuspid aortic valve with very calcified but also asymmetry in the degree of cusps' calcification (most on the posterior cusp)

Associated Aorta Atheroma

 

Conclusion

  • Very severe Ao Stenosis with very altered LV longitudinal function even if LVEF is preserved
  • Indication of surgery despite the absence of symptoms but could we afford a surgery in the context of breast cancer about to be treated?