Simultaneous transcatheter aortic valve implantation and drive-by endovascular aortic aneurysm repair: a case of lotus valve retrieved and replaced due to an undersized valve after an endovascular aneurysm repair.

A 79-year-old man with stable chronic obstructive pulmonary disease was found to have an abdominal aortic aneurysm and worsening dyspnoea. Echocardiography demonstrated critical aortic stenosis. Simultaneous endovascular aneurysm repair (EVAR) and transcatheter aortic valve replacement (TAVR) was recommended due to high surgical risk. Procedural strategy was to perform balloon valvuloplasty (BAV), followed by EVAR then TAVR. The initial 25 mm Lotus valve adopted a barrel shape suggestive of an undersized valve and was thus replaced with a 27 mm valve. Post procedural echo revealed no regurgitation. We report here for the first time a successful simultaneous TAVR/EVAR using the fully retrievable Lotus Valve.