Elderly patient for C3/4 laminectomy

PIG Meeting: 13th May 2021

80yr old female


  • Tissue AVR
  • AF


  • Missed cardiologist F/U
    • Missed annual TTE last year due to COVID issues
    • Previous TTE showed EF 40% (reduced from 50% the year before) and small paravalvular leak
    • DASI 6.6 METS
    • Plays golf weekly


  • Should surgery proceed without cardiologist F/U and TTE
  • Group consensus was that with reasonable exercise tolerance as per DASI and daily activities, nil clinical e/o heart failure, reasonable to proceed as planned.