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Transcatheter aortic valve implantation and closure of the left atrial appendage under cerebral protection

EuroIntervention 2012;8:640-641. DOI: 10.4244/EIJV8I5A98

Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
An 80-year-old male patient with symptomatic, severe aortic stenosis, coronary artery disease and permanent atrial fibrillation was referred for transcatheter aortic valve implantation (TAVI). After staged percutaneous coronary intervention of the LAD with drug-eluting stents, he suffered from recurrent lower gastro-intestinal bleeding under triple anticoagulation (acetylsalicylic acid, clopidogrel, and phenprocoumon). Due to high surgical risk (STS score 11.8%) and high risk for stroke (CHA2DS2-VASC score 6) and recurrent bleeding (HASBLED score 4), he underwent transfemoral TAVI (CoreValve 29 mm bioprosthesis; Medtronic, Minneapolis, MN, USA) and closure of the left atrial appendage (Watchman 27 mm device; Boston Scientific, Natick, MA, USA) with periprocedural use ...

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