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One-Stop TEVAR and TAVR Procedure for Severe Aortic Stenosis With Aortic Arch Aneurysm
Cheng Tan1, Jia Yi Weng1, Zhong Shan Gou1
1Department of Cardiology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China; Suzhou Key Laboratory of Cardiovascular Disease, Suzhou, China.
Background:
In recent years, transcatheter aortic valve replacement (TAVR) has become the fundamental treatment for patients with aortic stenosis (AS). Thoracic endovascular aortic repair (TEVAR) is also recommended for penetrating aortic ulcer. Especially in older patients with severe AS and penetrating aortic ulcer at the same time, the surgical method brings significant risk.
Case Summary:
We report a case of a 74-year-old male patient who presented with a 10-day history of dyspnea. He was diagnosed with severe AS with aortic valve insufficiency (penetrating aortic ulcer) and had multiple comorbidities. The patient underwent a 1-stop TEVAR + TAVR procedure.
Discussion:
The challenge was compounded by the patient's extremely narrow femoral access. This case demonstrates the 2 operations can be performed as a procedure.
Take-Home Messages:
Management of patients with severe AS and concurrent aortic pathology is complicated. One-stop TEVAR + TAVR procedure is viable and beneficial in such patients.
