How should I treat a patient with severe and symptomatic aortic stenosis who is rejected for surgical and transfemoral valve replacement and in whom a transapical implantation was aborted? Percutaneous reconstruction of the right ilio-femoral tract with balloon angioplasty followed by the implantation of self-expanding stents.
BACKGROUND
A 74 year old male with a history of postero-lateral myocardial infarction in 1993 and coronary bypass surgery in 1994 was referred to the outpatient clinic in a frail general condition with signs of dyspnoea at rest.


METHODS
Physical examination, electrocardiography, laboratory tests, coronary angiography, abdominal angiography, Echo-doppler, transesophageal echo.


METHODS
Aortic stenosis.


RESULTS
Valve replacement.
de Jaegere
Peter P T
PP
Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. p.dejaegere@erasmusmc.nl
van Dijk
Lukas C
LC
van Sambeek
Marc R H M
MR
Kappetein
Arie-Pieter
AP
Orellana Ramos
Francisco Javier
FJ
Maugenest
Annemarie
A
de Ronde-Tilmans
Marjo
M
Serruys
Patrick W
PW
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy*; D017023:Coronary Angiography; D005263:Femoral Artery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007083:Iliac Artery; D008297:Male; D018579:Patient Selection; D012720:Severity of Illness Index; D015607:Stents