An 86-year-old woman with severe aortic stenosis was thought to be at a high risk for surgical aortic valve replacement and inoperability due to old age and porcelain aorta. Furthermore, transcatheter aortic valve replacement (TAVR) was considered difficult due to high risk of coronary obstruction secondary to the aortic root anatomy and poor vascular access associated with marked atherosclerotic lesions on the distal aortic arch with peripheral artery disease. We successfully treated her with TAVR via the brachiocephalic artery in combination with prophylactic off-pump coronary artery bypass grafting.

中文翻译：

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一种不仅手术而且经导管主动脉瓣置换术风险高的病例的混合方法

一位患有严重主动脉瓣狭窄的 86 岁女性被认为由于高龄和瓷主动脉而处于外科主动脉瓣置换术和无法手术的高风险中。此外，经导管主动脉瓣置换术 (TAVR) 被认为是困难的，因为主动脉根部解剖结构继发冠状动脉阻塞的风险很高，并且血管通路与远端主动脉弓上明显的动脉粥样硬化病变相关并伴有外周动脉疾病。我们通过头臂动脉联合预防性非体外循环冠状动脉旁路移植术成功地对她进行了 TAVR 治疗。