Severe AS, timing of endoscopy

Gabrielle Morris

80+ yo male with + FOBT for colonoscopy.

Background

  • IDDM
  • IHD
  • OSA – untreated
  • BMI 47
  • Cognitive impairment
  • AF – warfarinised
  • SOBOE – 50m
  • Severe AS – mean gradient 50mmHg, ASA 0.87cm2

Issues

  • Severe AS – ? timing of procedure

Discussion

  • Patient will be for discussion at TAVI MDT
  • Results of colonoscopy will help to inform decision around TAVI
  • Identifying a treatable bowel lesion now, rather than delayed, may enable a more conservative management pathway
  • TAVI does require a brief period of anticoagulation post procedure however this patient is already anticoagulated for AF and nil overt bleeding issues
  • Appropriate to proceed to colonoscopy

Plan

  • Proceed to colonoscopy