Key result
Simultaneous TAVR and EVAR achieves successful repair without major adverse events at 3 months.
Case Report (n=1)
No
A single-stage combined TAVR and EVAR procedure is a viable and potentially safe therapeutic paradigm for surgical high-risk patients presenting with both severe aortic regurgitation and a concomitant giant abdominal aortic aneurysm.
May support simultaneous TAVR-EVAR in select high-risk patients; hypothesis-generating and requires prospective validation.
OBJECTIVE: We present an older male with severe aortic regurgitation scheduled for transcatheter aortic valve replacement (TAVR). Preoperative imaging identified a giant eccentric abdominal aortic aneurysm at high risk of rupture. This risk was mitigated by a single-stage combined procedure of TAVR and endovascular aneurysm repair. KEY STEPS: Two 8-F sheaths were respectively inserted into the bilateral femoral arteries. We then sequentially dilated the right femoral artery access using 14-F, 18-F, and 20-F introducer sheaths. The self-expanding stent system Endurant II was inserted and released. Coronary angiography assessed the degree of coronary artery stenosis. A 20-F sheath was inserted into the right femoral artery, and then we deployed the Evolut Pro + prosthetic valve. POTENTIAL PITFALLS: Potential pitfalls include the following: paravalvular leakage, valve displacement or detachment, and rupture of aneurysms. TAKE-HOME MESSAGE: For surgical high-risk patients with concurrent abdominal aortic aneurysm and severe aortic valve disease, the simultaneous implementation of TAVR and endovascular aneurysm repair may represent a viable therapeutic option.
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He et al. (2026) conducted a case report in Severe aortic regurgitation and giant abdominal aortic aneurysm (n=1). Simultaneous TAVR and EVAR was evaluated on Procedural success and freedom from major adverse cardiovascular events. Simultaneous TAVR and EVAR was successfully performed without major adverse cardiovascular events, endoleak, or paravalvular leakage at 3-month follow-up in a high-risk patient.
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