First report of simultaneous transcatheter aortic valve replacement, endovascular aortic aneurysm repair, and permanent pacemaker implantation after multi-vessel coronary stenting and left atrial appendage occlusion:
Key result
Fully percutaneous PCI, LAA occlusion, TAVI, EVAR, and PPM achieves asymptomatic recovery at three months.
- n=1
Population
One 67-year-old patient with acute STEMI, multivessel CAD, severe AS, and AAA
Design
Case report
Follow-up
3 months
Authors
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“This is the first report of simultaneous TAVI, EVAR, and PPM implantation. It demonstrates in a single patient the evolution of minimally invasive cardiovascular medicine culminating in a fully percutaneous repair of multiple coronary vessels, the aortic valve, and the aortic aneurysm while tackling bradyarrhythmias and excluding the need for oral anti-coagulation by left atrial appendage occlusion.”
Overview
Supports considering combined interventions in select high-risk elderly patients; leaves open need for larger trials to confirm outcomes.
Key Points
- To report the successful simultaneous performance of multiple cardiovascular interventions in a high-risk patient.
- 67-year-old patient with chronic renal failure and ST-elevation myocardial infarction.
- Interdisciplinary approach involving cardiologists, heart surgeons, and vascular surgeons.
- Simultaneous transcatheter aortic valve replacement, endovascular aortic aneurysm repair, and pacemaker implantation.
- Successful revascularization of the circumflex artery with drug eluting stents.
- Simultaneous aortic valve replacement and aneurysm repair completed without complications.
- Patient asymptomatic three months post-procedure.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
A 67-year-old patient with acute STEMI, severe aortic stenosis, and an abdominal aortic aneurysm treated with a fully percutaneous multi-intervention approach and followed for 3 months.
I
Intervention
Simultaneous transcatheter aortic valve implantation (TAVI), endovascular aneurysm repair (EVAR), and permanent pacemaker (PPM) implantation, following staged multi-vessel percutaneous coronary intervention (PCI) and left atrial appendage occlusion.
O
Outcome
Clinical recovery and symptom status
This case demonstrates the feasibility of a fully percutaneous, interdisciplinary approach combining TAVI, EVAR, and PPM implantation after PCI and LAA occlusion in a complex, high-risk patient.
Cite This Study
Binder et al. (2015) conducted a case report in Acute inferior-posterior STEMI, severe aortic valve stenosis, and abdominal aortic aneurysm (n=1). Simultaneous TAVI, EVAR, and PPM implantation after multi-vessel PCI and LAA occlusion was evaluated on Clinical recovery and symptom status. A fully percutaneous approach involving PCI, LAA occlusion, TAVI, EVAR, and PPM implantation was successfully performed in a 67-year-old patient, who was completely asymptomatic 3 months later.