Managing Cardiogenic Shock With Concurrent Transcatheter Aortic Valve Replacement and Percutaneous Coronary Intervention.

BACKGROUND

Cardiogenic shock secondary to concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) is a critical clinical condition requiring comprehensive management.

CASE SUMMARY: A 75-year-old man presented with cardiogenic shock resulting from severe AS and CAD. Emergency surgery was performed. It involved initiation of extracorporeal circulatory support, followed by percutaneous coronary intervention (PCI) and, subsequently, transcatheter aortic valve replacement (TAVR) using a TaurusElite valve (Peijia Medical). This strategy resulted in marked hemodynamic improvement.

DISCUSSION: This case highlights the efficacy and safety of concurrent PCI and TAVR as a lifesaving strategy for cardiogenic shock patients with concomitant severe CAD and AS.

TAKE-HOME MESSAGES: Emergency PCI with concurrent TAVR represents a viable lifesaving strategy for cardiogenic shock patients with coexisting severe CAD and AS. Prophylactic extracorporeal circulation initiation is critical in TAVR procedures for patients with cardiogenic shock to prevent circulatory collapse and maintain systemic perfusion.