Combined rotational atherectomy and aortic balloon valvuloplasty as a bridge to transcatheter aortic valve replacement

Patients with obstructive coronary artery disease and severe aortic stenosis have traditionally been managed with open heart surgery. In the era of transcatheter aortic valve replacement (TAVR) and high-risk coronary interventions many of those patients who were previously considered "terminal'' can now be successfully managed with percutaneous coronary intervention (PCI) and TAVR. Although simple PCI can be safely combined with TAVR in the same procedure, high-risk coronary interventions often need to be performed separately. We report the first case of combined rotational atherectomy with balloon aortic valvuloplasty as a bridge to TAVR in a frail patient with complex coronary artery disease and critical aortic stenosis. (C) 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.