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. 2020 Nov 24;4(6):1–6. doi: 10.1093/ehjcr/ytaa379
Timeline Event Result
1999 Coronary artery bypass graft Subsequent percutaneous coronary intervention to both saphenous vein grafts
2009 Bilateral iliac artery stenting Temporary relief of lower limb ischaemia symptoms
2011 Aortic stent graft to treat recurrent aortoiliac occlusive disease Relief of lower limb ischaemia symptoms
2013 Paroxysmal atrial fibrillation and left hemispheric stroke Full neurological recovery
2019 Worsening symptoms of aortic stenosis

Institutional Heart Team declined surgical aortic valve replacement

Transcatheter aortic valve implantation (TAVI) was suggested due to debilitating symptoms

2019 Multi-slice computed tomography for TAVI planning
  • Heavily calcified iliofemoral vasculature with maximum lumen diameters of 4.2 mm (right) and 4.3 mm (left)

  • Small right subclavian artery of 4.5 mm, bovine aortic arch with left vertebral artery arising from the aortic arch, and occluded left subclavian artery

  • Left common carotid artery calcified with 70% left internal carotid artery stenosis

2019 Transaortic TAVI and concomitant left carotid endarterectomy

Recovered well with no neurological deficit

Discharged within 72 h

Continues to do well 6 months post-operatively

2020 Coronavirus disease 2019 (COVID-19) positive Fully recovered