• Seok Oh, Ju Han Kim, Dae Young Hyun, Kyung Hoon Cho, Min Chul Kim, Doo Sun Sim, Young Joon Hong, Youngkeun Ahn, Myung Ho Jeong, Yochun Jung, and Kyo Sun Lee.
• Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
• Medicine (Baltimore). 2022 Jan 28; 101 (4): e28702e28702.

RationaleIn super-aged patients with severe symptomatic aortic stenosis, transcatheter aortic valve replacement (TAVR) is a good treatment option, and the number of TAVR-eligible elderly patients is expected to grow exponentially. We present the case of a nonagenarian woman with severe aortic stenosis who underwent successful subclavian TAVR.Patient ConcernsA 90-year-old Korean woman was brought to our department with dyspnea. On physical examination, a grade IV systolic murmur was auscultated in both the upper sternal borders and the left lower sternal border.DiagnosisA transthoracic echocardiogram showed heavy calcification of the aortic valve with an increase in both peak velocity (4.36 m/s) and mean pressure (44.8 mm Hg), indicating severe symptomatic aortic stenosis.InterventionsAfter a heart team conference involving interventional cardiologists, cardiac surgeons, and anesthesiologists, subclavian TAVR was performed. Using the left subclavian artery, we successfully deployed a self-expandable valve prosthesis (CoreValveTM Evolut RTM, Medtronic Inc., Minneapolis, MN).OutcomesAfter TAVR, transthoracic echocardiogram showed a decline in both peak velocity (2.06-2.14 m/s) and mean pressure (7.42-7.95 mm Hg) with an increase in the aortic valve area (1.12 cm2). The patient's dyspnea symptoms improved dramatically.LessonsIn addition to femoral TAVR, subclavian TAVR may be feasible and safe in super-aged patients.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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