Transcatheter Aortic Valve Implantation in an Octogenarian Patient with Single Coronary Artery

Aims: We herein report the case of a patient with severe aortic stenosis and a single coronary artery arising from the right sinus of valsalva, who successfully underwent transcatheter aortic valve implantation (TAVI).

Case Presentation: A 86-year-old Caucasian woman was admitted with acute coronary syndrome. Coronary angiography and transthoracic echocardiography revealed the coexistence of single coronary artery and severe aortic stenosis. The patient underwent successful TAVI with Edwards SAPIEN XT valve.

Discussion: Single coronary artery is a rare congenital coronary artery anomaly. Its coexistence with severe aortic stenosis in the context of acute coronary syndrome is even rarer. Knowledge is scarce about feasibility and safety of TAVI in patients with coronary artery anomalies. This procedure is associated with a very low incidence of coronary obstruction, a catastrophic complication in the setting of a single coronary ostium.

Conclusion: This case highlights that TAVI can be safely performed in carefully selected patients with single coronary artery.