Two patients treated with simultaneous EVAR and TAVI

Abstract

Objectives: The combination of severe aortic stenosis (AS) and abdominal aortic aneurysm (AAA) is not uncommon in elderly patients and should be optimally managed. However, the guidelines do not provide recommendations for clinical practice, thus reinforcing the need for further analysis of this complex, challenging condition. Methods: We report 2 cases of patients with severe AS patients with high surgical risk for aortic valve replacement (AVR) and AAA with a diameter of more than 5.5 cm who underwent simultaneous transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (EVAR). Results: The patients were successfully treated with EVAR and TAVI and had an uncomplicated postoperative course. The importance of this combined pathological condition is emphasised as the need for simultaneous treatment with an endovascular technique, after a thorough study of the clinical and imaging data of the patients and decision-making by the teams of interventional cardiologists and vascular surgeons. The case reports are limited to one or a small number of incidents that occurred simultaneously or sequentially, without specifying the most appropriate method. Conclusions: Severe AS and AAA can be treated with combined procedures with EVAR followed by TAVI simultaneously, with a safe and effective result. The study by a multidisciplinary team highlights the importance of a thorough evaluation of all patients before intervention and the need for more studies and guidelines.

Keywords

• Aortic stenosis
• Cardiac aortic valve replacement
• TAVI
• Abdominal aortic aneurysm
• EVAR