{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T04:40:05Z","timestamp":1746333605188,"version":"3.40.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Rationale:<\/jats:title>\n            <jats:p>In 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient concerns:<\/jats:title>\n            <jats:p>A 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Diagnosis:<\/jats:title>\n            <jats:p>A transthoracic echocardiogram showed heavy calcification of the aortic valve with an increase in both peak velocity (4.36\u200am\/s) and mean pressure (44.8\u200amm Hg), indicating severe symptomatic aortic stenosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>After 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 (CoreValve<jats:sup>TM<\/jats:sup> Evolut R<jats:sup>TM<\/jats:sup>, Medtronic Inc., Minneapolis, MN).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcomes:<\/jats:title>\n            <jats:p>After TAVR, transthoracic echocardiogram showed a decline in both peak velocity (2.06\u20132.14\u200am\/s) and mean pressure (7.42\u20137.95\u200amm Hg) with an increase in the aortic valve area (1.12\u200acm<jats:sup>2<\/jats:sup>). The patient's dyspnea symptoms improved dramatically.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Lessons:<\/jats:title>\n            <jats:p>In addition to femoral TAVR, subclavian TAVR may be feasible and safe in super-aged patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000028702","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T14:04:13Z","timestamp":1643378653000},"page":"e28702","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Successful subclavian transcatheter aortic valve replacement in a nonagenarian patient"],"prefix":"10.1097","volume":"101","author":[{"given":"Seok","family":"Oh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3186-0770","authenticated-orcid":false,"given":"Ju Han","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"},{"name":"Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Young","family":"Hyun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Hoon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min Chul","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"},{"name":"Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doo Sun","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"},{"name":"Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Joon","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"},{"name":"Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngkeun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"},{"name":"Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myung Ho","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea"},{"name":"Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yochun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Thoracic Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyo Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"R1-20250504","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: a population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"key":"R2-20250504","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1056\/NEJMra1313875","article-title":"Aortic-valve stenosis\u2013from patients at risk to severe valve obstruction","volume":"371","author":"Otto","year":"2014","journal-title":"N Engl J Med"},{"key":"R3-20250504","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1161\/01.CIR.0000047200.36165.B8","article-title":"Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description","volume":"106","author":"Cribier","year":"2002","journal-title":"Circulation"},{"key":"R4-20250504","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1016\/j.jacc.2018.08.2146","article-title":"5-Year outcomes of self-expanding transcatheter versus surgical aortic valve replacement in high-risk patients","volume":"72","author":"Gleason","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"R5-20250504","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1056\/NEJMoa1514616","article-title":"Transcatheter or surgical aortic-valve replacement in intermediate-risk patients","volume":"374","author":"Leon","year":"2016","journal-title":"N Engl J Med"},{"key":"R6-20250504","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1016\/S0140-6736(15)60308-7","article-title":"5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial","volume":"385","author":"Mack","year":"2015","journal-title":"Lancet"},{"key":"R7-20250504","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"N Engl J Med"},{"key":"R8-20250504","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","author":"Popma","year":"2019","journal-title":"N Engl J Med"},{"key":"R9-20250504","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1056\/NEJMoa1700456","article-title":"Surgical or transcatheter aortic-valve replacement in intermediate-risk patients","volume":"376","author":"Reardon","year":"2017","journal-title":"N Engl J Med"},{"key":"R10-20250504","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1161\/CIR.0000000000000923","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology\/American heart association joint committee on clinical practice Gguidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"R11-20250504","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.gheart.2017.02.002","article-title":"Is TAVR ready for the global aging population?","volume":"12","author":"Bergmann","year":"2017","journal-title":"Glob Heart"},{"key":"R12-20250504","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.jcin.2019.02.031","article-title":"Transfemoral TAVR in nonagenarians: from the CENTER Collaboration","volume":"12","author":"Vlastra","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"R13-20250504","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.amjcard.2015.06.033","article-title":"Comparison of outcomes of transcatheter aortic valve implantation in patients >\/=90 years Versus <90 years","volume":"116","author":"Abramowitz","year":"2015","journal-title":"Am J Cardiol"},{"key":"R14-20250504","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.amjcard.2019.06.026","article-title":"Comparison of outcomes of transcatheter aortic valve implantation in patients aged >90 years vs <90 years","volume":"124","author":"Stehli","year":"2019","journal-title":"Am J Cardiol"},{"key":"R15-20250504","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/j.amjcard.2012.05.058","article-title":"Comparison of effectiveness and safety of transcatheter aortic valve implantation in patients aged >\/=90 years versus <90 years","volume":"110","author":"Yamamoto","year":"2012","journal-title":"Am J Cardiol"},{"key":"R16-20250504","first-page":"01","article-title":"Transcatheter aortic valve implantation in a nonagenarian with aortic aneurysm: futility or utility?","volume":"2018","author":"Fennelly","year":"2018","journal-title":"Case Rep Cardiol"},{"key":"R17-20250504","first-page":"196","article-title":"Transcatheter aortic valve replacement in a nonagenarian","volume":"40","author":"Kneitz","year":"2013","journal-title":"Tex Heart Inst J"},{"key":"R18-20250504","doi-asserted-by":"crossref","first-page":"193","DOI":"10.4103\/sni.sni_208_17","article-title":"Successful cerebral thrombectomy for a nonagenarian with stroke in the subacute phase after transcatheter aortic valve implantation","volume":"8","author":"Matsuo","year":"2017","journal-title":"Surg Neurol Int"},{"key":"R19-20250504","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1007\/s00277-019-03646-6","article-title":"Successful management of transcatheter aortic valve implantation by platelet transfusions in a nonagenarian patient with severe autoimmune factor V deficiency","volume":"98","author":"Mouton","year":"2019","journal-title":"Ann Hematol"},{"key":"R20-20250504","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3390\/geriatrics2030025","article-title":"Never too late: a case report on transcatheter aortic valve implantation in a 97-year-old patient","volume":"2","author":"Zegrean","year":"2017","journal-title":"Geriatrics (Basel)"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000028702","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T04:27:34Z","timestamp":1746332854000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000028702"}},"subtitle":["Case report and review of literature"],"short-title":[],"issued":{"date-parts":[[2022,1,28]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000028702","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"type":"print","value":"0025-7974"},{"type":"electronic","value":"1536-5964"}],"subject":[],"published":{"date-parts":[[2022,1,28]]},"assertion":[{"value":"2021-12-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}