Key result
One-stop ECMO-assisted TAVR and PCI improves LVEF to ~72% in a high-risk patient.
Why the study?
Aortic stenosis is frequently associated with coronary artery disease, particularly in high-risk patients for whom treatment strategies lack standardized clinical guidelines.
Case Report (n=1)
No
A one-stop procedure combining V-A ECMO-assisted PCI and TAVR is feasible and effective for high-risk patients with severe aortic stenosis, complex coronary artery disease, and severe heart failure.
May support combined ECMO-assisted TAVR+PCI for LVEF recovery in high-risk severe AS with CAD; leaves open need for prospective validation.
Aortic stenosis (AS) is frequently associated with coronary artery disease (CAD), particularly in high-risk patients for whom treatment strategies lack standardized clinical guidelines. We report a case of a patient with severe AS and high-risk CAD, leading to significant heart failure, for whom surgical aortic valve replacement and coronary artery bypass grafting were unsuitable because of very high risk of morbidity and mortality. The patient underwent a one-stop procedure combining extracorporeal membrane oxygenation (ECMO)-assisted transcatheter aortic valve replacement (TAVR) and percutaneous coronary intervention (PCI). During the procedure, the patient first received preventive veno-arterial ECMO placement, successfully underwent PCI on the right coronary artery and left anterior descending artery, and then TAVR was performed without complications. The patient tolerated the procedure well, with hemodynamics remaining stable throughout. At one-year follow-up, the patient's heart function was significantly improved. This case provides valuable experience in treating high-risk AS combined with CAD, demonstrating the feasibility and effectiveness of this approach in clinical practice.
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Zhang et al. (2025) conducted a case report in Severe aortic stenosis and complex coronary artery disease with acute heart failure (n=1). One-stop ECMO-assisted transcatheter aortic valve replacement (TAVR) and percutaneous coronary intervention (PCI) was evaluated on Echocardiographic and clinical improvement. A one-stop procedure combining ECMO-assisted TAVR and PCI successfully improved left ventricular ejection fraction from 36.6% to 72.3% at one year in a high-risk patient with severe aortic stenosis and complex coronary artery disease.
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