title: Combined percutaneous coronary intervention and transcatheter aortic valve implantation in cardiogenic shock.
abstract: Transcatheter aortic valve implantation (TAVI) is a therapeutic option for patients with severe aortic valve stenosis and high surgical risk. Data concerning combined TAVI and percutaneous coronary intervention (PCI) as an alternative treatment to surgery in high-risk patients with aortic valve stenosis and concomitant coronary artery disease (CAD) are limited, and no prior cases of an emergency procedure in cardiogenic shock have been described. Herein is presented the case of a 53-year-old patient admitted in cardiogenic shock due to subacute myocardial infarction as well as high-grade aortic valve disease. Because of a prior history of mediastinal irradiation and the patient's unstable condition, an immediate percutaneous procedure was successfully performed with sequential transfemoral PCI and TAVI. The patient gradually recovered with a markedly improved left ventricular function and good quality of life. In conclusion, a single-stage combined approach is reasonable even in an emergency setting, and can lead to a good shortterm outcome. However, further reports and experience are needed to evaluate the feasibility of this approach.
authors.affiliation: Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany. jana-sofia.steude@web.de
authors.forename: Jana Sofia
authors.initials: JS
authors.lastname: Steude
authors.affiliation: Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Wahab
authors.affiliation: Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schubring
authors.affiliation: Heart Center, Segeberger Kliniken GmbH (Academic Teaching Hospital of the Universities of Kiel and Hamburg), Bad Segeberg, Germany.
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004630:Emergencies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011788:Quality of Life; D020127:Recovery of Function; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D016277:Ventricular Function, Left