A case of severe aortic valve stenosis including triple-vessel ischemic heart disease in which multidisciplinary percutaneous coronary intervention and balloon aortic valvuloplasty relieved low cardiac output syndrome.

Abstract

The patient was an 80-year-old man with low cardiac output syndrome associated with triple-vessel ischemic heart disease and severe aortic stenosis (AS). Deeming the patient unprepared for surgery because of his deteriorated general condition, we decided to perform revascularization with a percutaneous coronary intervention associated with intra-aortic balloon pump (IABP) and treat the severe AS with percutaneous balloon aortic valvuloplasty (BAV). Complete revascularization was successfully achieved and BAV was performed, improving the aortic valve area from 0.58 to 0.92cm(2) and the pressure gradient from 41 to 26mmHg. Postoperative hemodynamics improved, and the IABP was successfully removed.