Successful Simultaneous Transfemoral Aortic Valve Implantation and Endovascular Aortic Repair for Severe Aortic Valve Stenosis and Abdominal Aortic Aneurysm with Local Anesthesia

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Severe aortic valve stenosis and abdominal aortic aneurysm (n=1). Intervention: Simultaneous transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR) under local anesthesia with mild sedation. Primary outcome: Procedural success and postoperative complications.

Q: What does this research mean for the field?

Simultaneous transfemoral TAVI and EVAR under local anesthesia with mild sedation is feasible and safe for treating concomitant severe aortic stenosis and abdominal aortic aneurysm in high-risk patients unable to undergo general anesthesia. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Kayo Sugiyama; Naoaki Kano; Yasuhiro Ogawa; TOMOYO IKEDA; Keita Mamiya; Hiroto Suenaga; Shiro Tomari

doi:10.33290/jtvt.cr.26-0008

January 1, 2026Journal of Transcatheter Valve TherapiesOpen Access

Successful Simultaneous Transfemoral Aortic Valve Implantation and Endovascular Aortic Repair for Severe Aortic Valve Stenosis and Abdominal Aortic Aneurysm with Local Anesthesia

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Key result

Simultaneous TAVI and EVAR under local anesthesia is feasible in high-risk aortic disease.

n=1

Why the study?

Simultaneous TAVI and EVAR under local anesthesia with mild sedation are rarely reported despite some cases of combined procedures.

Key Points

To report the procedural feasibility and management of simultaneous transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR) under local anesthesia with mild sedation (LAS).
Treated an 87-year-old male presenting with severe aortic valve stenosis, a large abdominal aortic aneurysm, and severe chronic obstructive pulmonary disease (COPD) that precluded general anesthesia.
Performed simultaneous transfemoral TAVI and EVAR under LAS using percutaneous puncture access with hemodynamic management by an experienced anesthesiologist.
Intraoperative angiography identified perivalvular leakage that was undetectable on transthoracic echocardiography, which was successfully treated with postprocedural balloon aortic valvuloplasty.
Simultaneous TAVI and EVAR were completed without procedural or critical pulmonary complications, and the patient was discharged 5 days postoperatively.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

An 87-year-old male with severe aortic valve stenosis, a large abdominal aortic aneurysm, and severe COPD who underwent simultaneous TAVI and EVAR and was followed for 3 months.

I

Intervention

Simultaneous transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR) under local anesthesia with mild sedation (LAS)

O

Outcome

Procedural success and clinical status postoperatively

Limitations

Imaging evaluation using transthoracic echocardiography can be difficult in patients with severe COPD under local anesthesia, requiring angiography or other imaging modalities.
Difficulty of obtaining clear imaging evaluation (TTE) under local anesthesia in patients with severe COPD
Increased costs for simultaneous procedure
Higher contrast agent doses during simultaneous procedure
Increased radiation exposure

Implication

Simultaneous TAVI and EVAR under local anesthesia with mild sedation is a feasible and safe strategy for treating severe AS and giant AAA in elderly patients at prohibitively high surgical risk for general anesthesia.

Abstract

Objective: A few cases of simultaneous transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR) have been reported. Nonetheless, simultaneous TAVI and EVAR under local anesthesia with mild sedation (LAS) are rare. Herein, we report a case of severe aortic valve stenosis (AS) concomitant with a giant abdominal aortic aneurysm (AAA) that was successfully treated with simultaneous TAVI and EVAR under LAS.

Discussion

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Cite This Study

Sugiyama et al. (2026) conducted a case report in Severe aortic valve stenosis and abdominal aortic aneurysm (n=1). Simultaneous transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR) under local anesthesia with mild sedation was evaluated on Procedural success and postoperative complications. Simultaneous TAVI and EVAR under local anesthesia was successfully performed in an 87-year-old patient with severe aortic stenosis, an abdominal aortic aneurysm, and severe COPD.

synapsesocial.com/papers/6ad0fc263afa093ea9acfc37 https://doi.org/10.33290/jtvt.cr.26-0008

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Successful Simultaneous Transfemoral Aortic Valve Implantation and Endovascular Aortic Repair for Severe Aortic Valve Stenosis and Abdominal Aortic Aneurysm with Local Anesthesia

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Successful Simultaneous Transfemoral Aortic Valve Implantation and Endovascular Aortic Repair for Severe Aortic Valve Stenosis and Abdominal Aortic Aneurysm with Local Anesthesia

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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