Transcatheter aortic valve implantation in a patient with severe aortic valve stenosis, colon cancer, and obstructive ileus: A case report

Abstract

An 82-year-old woman with symptomatic severe aortic stenosis (AS) developed an obstructive ileus caused by colon cancer. Colectomy was considered a high-risk surgery due to both the severe AS and obstructive ileus. Therefore, we planned placement of a colonic stent for the obstructive ileus. After stenting, we performed transcatheter aortic valve implantation (TAVI) instead of surgical aortic valve replacement (SAVR), because of the risk of bleeding during extracorporeal circulation and the perioperative risk of AVR (Society of Thoracic Surgery predicted risk of mortality: 7.4%). Successful colonic stenting and TAVI allowed a safer colectomy. The period from TAVI to colectomy was 12 days. TAVI could be useful for symptomatic severe AS in high-risk patients prior to non-cardiac surgery, especially for malignant tumors.<Learning objective: In patients with symptomatic severe aortic stenosis, aortic valve replacement is recommended prior to non-cardiac surgery. However, in patients with a malignancy, the complications due to the tumor and the risk of extracorporeal circulation remain a challenge in surgical aortic valve replacement. In such cases, transcatheter aortic valve implantation may be a useful option to reduce the incidence of complications and the time to surgery for the malignancy.>