🙌 TF-TAVR for elderly female with 20% EF + chronic severe AI and no leaflet calcium using over sized Portico 29 mm with anchor at annulus + STJ + Asc. Aorta. No PVL / PPM (post LBBB) Possible with careful CT analysis! @NBrozziMD Jerry Estep Jose Luis Navia, MD Cleveland Clinic Florida

60 yo F (170 cm) Hx balloon valvuloplasty for Rheumatic MS 20 years ago. NYHA III from recurrent severe MS. 🙌 Successful redo MVBP with 28 mm Inoue. Pre MVA 1 gradient 11 mmHg Post MVA 1.9 gradient 6 mmHg + medial commissural mild MR. Jose Luis Navia, MD Jerry Estep Cleveland Clinic Florida

🙌 Successful collaboration with Lourdes Prieto to treat a 40 year old female with coarctation of aorta (PG 65 mmHg) & resistant HTN > NuDEL 18 x 40 mm premounted covered stent (no post dilatation). Jose Luis Navia, MD Jerry Estep Cleveland Clinic Florida

80 yo Hx AVR Trifecta 27 (2014) > Clinic: NYHA IV >> ED: Pulm Edema + AKI from severe AI. 🙌 Successful non-con MAC Evolut FX 29 ViV (no post dil). Collective 💪 ED, Hospitalist, Pulm, Renal, Card > home with recovered kidneys & lungs. Cleveland Clinic Florida Jose Luis Navia, MD Jerry Estep

82 yo male > Mosaic 27 mm MVR (2003) with flail leaflet > 🙌💪Successful trans septal access (VersaCross) > septostomy (12 mm) > S3 Ultra 26 mm > 26 mm Post Dil (Atlas). No LVOT gradient\shunt. Sentinel for cerebral protection🤔 Cleveland Clinic Florida Jose Luis Navia, MD Jerry Estep

Challenging case: Active nonagenarian > recurrent HF admissions > 15 YO Magna 21. Low LM/STJ + narrow sinus 🙌 Successful Guideliner assisted BASILICA + Evolut FX 23 ViV (No post dil). Rt subclavian stenosis (no sentinel). Home in few days after recovering from minor CVA 🙏 😇

After 11 years of service, Sapien (23 mm) valve degenerative dysfunction > severe AI. Successful ViV TAVR using Sapien 3 Ultra 23 mm (+1 cc). Echo MG 10 mmHg. Excellent coronary access for this patient with recurrent revasc needs. Excited to join the distinguished team at Cleveland Clinic Abu Dhabi

Middle-aged male with Hx of Carcinoid heart disease > 5 years old Tricuspid Biocor 29 mm > presents with symptomatic severe tricuspid valve stenosis. Successful Transjugular MAC TTVR ViV using S3 Ultra 26 (+2 cc) Cleveland Clinic Abu Dhabi structural team.

Exciting day 🙌 for Cleveland Clinic Abu Dhabi structural team! Two successful Tricvalve cases for diuretic resistant symptomatic torrential tricuspid regurgitation not amenable for TEER. Impressive hemodynamic result (IVC V wave from 40 to 20 mmHg) 👍

Young patient with NYHA III DOE + Hemoptysis > Severe rheumatic mitral stenosis (MG 17 MVA 0.6) > nice hemodynamic and anatomic result (MG 5 MVA 1.5) following BMVP using 26 mm Inoue balloon (stable +1 MR) at Cleveland Clinic Abu Dhabi structural cardiology team 🙌

35 yr patient in CS on VA-ECMO with severe cardiomyopathy (LVEF 15%) and critical AS > inadequate result with 25 mm BAV > Great hemodynamic result with S3 29 TAVR + ECMO decannulation under MAC. 🙌Detailed planning and successful implementation 💪 Cleveland Clinic Abu Dhabi HF & structural teams.

Patient with DOE and systemic venous congestion + AKI found to have hypermetabolic RA mass protruding into RV > tricuspid valve inflow obstruction > ICE guided biopsy > rare case of high grade cardiac B cell lymphoma confirmed on pathology

80 yo NYHA III DOE > Severe aortic valve regurgitation > successful TF-TAVR using Navitor 25 mm (annular perimeter 66 mm) with great echocardiographic and hemodynamic results 🙌💪Cleveland Clinic Abu Dhabi

Elderly frail male (46 Kg BMI 13) with emphysema > worsening dyspnea (NYHA III) > found to have severe flail MR. Vertical heart & abundance of chordae created a challenge > Successful TEER 👏💪 using two PASCAL ACE implants. Great immediate hemodynamic effect Cleveland Clinic Abu Dhabi

Collection of bicuspid aortic valve stenosis undergoing TAVR with Sapien 3 Cleveland Clinic Abu Dhabi Careful anatomical screening for successful technical & clinical outcomes 🤲💪 Spotlight 🔦 on metanalysis & need for RCT (TAVR vs SAVR, balloon vs self expanding, annular vs supra annular)

Neisseria Meningitidis causing primary bacterial pericarditis > rapidly growing pericardial effusion leading to tamponade > managed successfully with pericardiocentesis and IV antibiotics Cleveland Clinic Abu Dhabi

Nice "extra" tool to have for structural interventions! CT-Fluoroscopy coregistration Cleveland Clinic Abu Dhabi

Simultaneous TAVR (Evolut FX 23 > Post Atlast 20) + TMVR ViV (S3 U 26 + 2 cc) in prior Magna 21 AVR + Perimount 27 MVR. Great structural team planning & implementation 💪🙌 Cleveland Clinic Abu Dhabi

70 yo morbidly obese Hx of CVA/A.Fib > NYHA III LVEF 15-20% LBBB with Severe Aortic Regurgitation > R+L Bicuspid with Minimal calcification on NC leaflet. Successful TAVR with Evolut FX 34 (Annular Perimeter 85) Cleveland Clinic Abu Dhabi

80 yo F > AS in prior Magna Ease # 23 with MG 70 + Asc Ao Aneurysm (45 mm). Nose cone of Fx 26 would not slide into LV even with 20 mm predil + Lunderquist wire. Successful Snare Sling Technique over Safari moving Fx away from outer curve sliding across Magna > Final MG ~ 5 🙌