Aortic Valve Stenosis and Insufficiency Combined With Aortic Coarctation.

BACKGROUND

The coexistence of aortic valve stenosis and regurgitation with native coarctation is a rare and complex condition in adults, especially those with significant surgical risks, complicating management.

CASE SUMMARY: A 60-year-old male with poorly controlled hypertension, chronic kidney disease, and atrial fibrillation presented with progressive dyspnea and chest tightness. Echocardiography revealed a bicuspid aortic valve with moderate stenosis and regurgitation, reduced ejection fraction, and left ventricular dilation. Computed tomography showed near-occlusive coarctation of the descending aorta. Given high surgical risk, conventional surgery was deemed unfeasible.

DISCUSSION: A single-session transcatheter "one-stop" approach, combining balloon angioplasty, aortic valve replacement, and stent implantation, was performed, resulting in immediate hemodynamic improvement.

TAKE-HOME MESSAGE: A unified, single-session transcatheter strategy offers a safe and effective alternative for high-risk patients with aortic valve disease and coarctation.