Single-Stage Procedure of Transcatheter Aortic Valve Replacement and Endovascular Aneurysm Repair Under Local Anaesthesia and Percutaneous Access

Vasc Endovascular Surg. 2023 Nov;57(8):949-953. doi: 10.1177/15385744231183499. Epub 2023 Jun 13.

Abstract

Purpose: Abdominal aortic aneurysms (AAA) are observed in 6% of patients with concomitant aortic valve stenosis (AS) requiring aortic valve replacement. Optimal management of these concomitant pathologies is still debated.

Case report: An 80-year-old man presented with acute heart failure due to a severe AS. Past medical history included AAA under regular surveillance. A thoracic and abdominal computed tomography angiography (CTA) confirmed a 6 mm increase of AAA over an 8-month period (max 55 mm). A multidisciplinary team prescribed a simultaneous endovascular approach of transcatheter aortic valve implantation (TAVI) followed by endovascular aneurysm repair (EVAR) under local anaesthesia with bilateral femoral percutaneous access. No intra or post-procedural complications were registered; technical success was confirmed by completion angiography and post-operative ultrasound. The patient was discharged on postoperative day 5. A 2-month post-operative CTA confirmed ongoing technical success.

Conclusion: Combined TAVI and EVAR under local anaesthesia for AS and AAA was associated with reduced hospital stay and technical success at 2 months from intervention in this case report.

Keywords: abdominal aortic aneurysm; aortic valve stenosis; combined procedure; endovascular aortic repair; transcatheter aortic valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anesthesia, Local
  • Aortic Aneurysm, Abdominal* / complications
  • Aortic Aneurysm, Abdominal* / diagnostic imaging
  • Aortic Aneurysm, Abdominal* / surgery
  • Aortic Valve
  • Aortic Valve Stenosis* / complications
  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / surgery
  • Blood Vessel Prosthesis Implantation* / methods
  • Endovascular Aneurysm Repair
  • Endovascular Procedures* / methods
  • Humans
  • Male
  • Transcatheter Aortic Valve Replacement* / methods
  • Treatment Outcome