 Iotic stenosis is where Iotic wall gets up to dead and patient starts becoming breathless and they start developing chest pain and for you know there is a very good alternative to surgery otherwise ideally surgery was the only treatment. Now we have an alternative which we call as TAVI or TAVAR means it's like you're changing the Iotic wall but not with surgery you're going to do it with like angioplasty so there are no cuts there are no stitches and patient recovers very fast so today we're going to talk about one of our very close patient who is a post renal transplant patient. Now she developed Iotic stenosis and she started feeling fatigue and she started feeling breathless and her effort tolerance came down the echocardiogram showed a severe Iotic wall problem with Iotic stenosis. TAVI is a procedure in which we do through the femoral artery it's run under local anesthesia for this patient no general anesthesia a little bit sedation post-precision immediately she's mobilized.