{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:25:43Z","timestamp":1762431943096,"version":"3.41.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Transcatheter aortic valve implantation (TAVR) continues to develop as a valuable alternative to surgical aortic valve replacement (SAVR) in an increasingly wide spectrum of patients with severe symptomatic aortic stenosis (AS). AS frequently coexists with coronary artery disease, and performing technically challenging percutaneous coronary intervention (PCI) following TAVR will become more frequent with increased use of TAVR.<\/jats:p><jats:p><jats:bold>Case Summary:<\/jats:bold> We herein report the case of a 53-years-old man with complex medical history including type 1 diabetes and dialysis-dependent renal failure and prior Evolut-R TAVR for critical bicuspid aortic valve stenosis who underwent intravascular ultrasound study (IVUS)-guided PCI to a critical distal left main stem (LMS) and proximal left anterior descending (LAD) lesion after presenting with ventricular fibrillation (VF) secondary to an acute coronary syndrome (ACS).<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> Selective engagement of coronary ostia through the side cells of TAVR prosthesis can be challenging, especially in an emergency setting. The particular challenges associated with this case are described, as well as an up-to-date literature search on strategies and equipment that can help in this situation.<\/jats:p>","DOI":"10.3389\/fcvm.2020.620272","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T05:59:21Z","timestamp":1611122361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Emergency High-Risk Percutaneous Coronary Intervention Following Transcatheter Aortic Valve Implantation in Bicuspid Anatomy"],"prefix":"10.3389","volume":"7","author":[{"given":"Ahmed","family":"El-Medany","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemina","family":"Doolub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amardeep","family":"Dastidar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Dorman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,1,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2714","DOI":"10.1093\/eurheartj\/ehi471","article-title":"Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery?","volume":"26","author":"Iung","year":"2005","journal-title":"Eur Heart J."},{"key":"B2","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.jacc.2019.06.012","article-title":"Coronary artery disease and transcatheter aortic valve replacement: JACC state-of-the-art review","volume":"74","author":"Faroux","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1056\/NEJMoa1514616","article-title":"Transcatheter or surgical aortic-valve replacement in intermediate-risk patients","volume":"374","author":"Leon","year":"2016","journal-title":"N Engl J Med."},{"key":"B4","unstructured":"UK TAVR Trial"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.jacc.2018.01.057","article-title":"Coronary angiography and percutaneous coronary intervention after transcatheter aortic valve replacement","volume":"71","author":"Yudi","year":"2018","journal-title":"J Am Coll Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx470","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2013.01.096","article-title":"Severe aortic stenosis and coronary artery disease\u2014implications for management in the transcatheter aortic valve replacement era: a comprehensive review","volume":"62","author":"Goel","year":"2013","journal-title":"J Am Coll Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1093\/eurheartj\/ehu278","article-title":"2014 ESC\/EACTS guidelines on myocardial revascularization: the task force on myocardial revascularization of the European society of cardiology (ESC) and the European association for cardiothoracic surgery (EACTS). 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