TCTAP C-226 Buying Time with Urgent Balloon Aortic Valvuloplasty While Awaiting for TAVI in a Hemodynamic Unstable Patient with Severe Aortic Stenosis and Very Poor Ejection Fraction

[Clinical Information] Patient initials or identifier number A072993 Relevant clinical history and physical exam 69-year-old lady Chief complaint: severe dyspnea, orthopnea and cold sweating for one day Medical history: severe aortic stenosis, paroxysmal atrial fibrillation BP: 80/50 mmHg CXR: acute pulmonary edema Transthoracic echocardiography: very poor systolic function, ejection fraction of about 16%, bicuspid aortic valve with severe calcification, aortic valve area of about 0.3 cm2 by continuity equation Logistic Euroscore: 50% Relevant test results prior to catheterization Aortic root angiography: severely calcified aortic valve with restricted motion, mild aortic regurgitation Coronary angiography: only luminal change and no obvious stenosis of coronary arteries Peak-to-peak pressure gradient of left ventricle and aortic root was about 130mmHg.