Severe aortic stenosis, critical coronary artery disease, and transfusion-dependent angiodysplasia - A management conundrum.

The combination of severe aortic stenosis, bleeding due to Heyde's syndrome and critical coronary artery disease presents a management challenge. We report the case of an 86-year-old who underwent percutaneous coronary intervention to the right coronary artery, simultaneous balloon aortic valvuloplasty to treat aortic stenosis and address bleeding from Heyde's syndrome, and subsequent staged transcatheter aortic valve implantation. <Learning objective: The combination of severe aortic stenosis (AS), bleeding due to Heyde's syndrome and critical coronary artery disease presents a management challenge. This case demonstrated the efficacy of balloon aortic valvuloplasty in resolving gastrointestinal bleeding, with intravascular ultrasound-guided percutaneous coronary intervention with a bare metal stent and single anti-platelet therapy safely and effectively addressing critical coronary stenosis, allowing definitive treatment of AS by transcatheter aortic valve implantation to be performed as a staged procedure.>.