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.>.