An Alternative Approach for Very High-risk Non-operative Patients with Severe Aortic Stenosis and Multivessel Coronary Disease - Staged Coronary Angioplasty and Transcatheter Aortic Valve Implantation – Case Report and Review of Literature

The Aim : The management of obstructive coronary artery disease before the transcatheter aortic valve implantation (TAVI) is not yet well established. Presentation of Case: We describe a 68-year-old patient with severe aortic stenosis, multivessel coronary artery disease, severe left ventricle dysfunction and several co-morbidities, who was disqualified from aortic valve replacement concomitant to coronary artery by-pass grafting because of excessive operative risk (logistic EuroScore 27.62%, STS 13.3% risk of mortality). After careful assessment he was treated with staged percutaneous coronary intervention (PCI) of the left main