title: Dawn of a new era: the completely interventionally treated patient.
abstract: A frail 75-year-old woman with permanent atrial fibrillation and angina pectoris was admitted to our department for further evaluation. Echocardiography revealed concurrent severe aortic valve stenosis. Furthermore, significant coronary artery stenoses were identified on the coronary angiogram. We chose the following treatment strategy: first, two drug eluting stents were implanted successfully in the left anterior descending and circumflex artery, respectively. Second, a 23 mm Core Valve bioprosthesis (Medtronic Inc, Minneapolis, Minnesota, USA) was implanted without complications within the same session. Two weeks after hospital discharge, the patient showed up at our outpatient department, with a symptomatic complete atrioventricular-block with an escape rhythm of 35 bpm. Thus, finally, a leadless pacemaker Micra (Medtronic Inc) was implanted via a transvenous transfemoral access without any complications.
authors.affiliation: Cardiovascular Division, General and University Teaching Hospital Linz, Linz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kypta
authors.affiliation: Linz General Hospital Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.affiliation: Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Lichtenauer
authors.affiliation: Linz General Hospital Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Steinwender
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D054537:Atrioventricular Block / Q000150:complications; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy; D054855:Drug-Eluting Stents; D004452:Echocardiography; D004867:Equipment Design; D005260:Female; D016330:Frail Elderly; D006801:Humans; D010138:Pacemaker, Artificial