CONGRESS ABSTRACT

We report a case of a 59-year-old male patient with a history of atrial fibrillation, heart failure, LF-LG (low-flow low-gradient) valvular AS (aortic stenosis) “EF 40%, stroke volume index (SVi) 20 ml/m², mean gradient 29 mmHg, aortic valve area (AVA) 0.7 cm², indexed AVA 0.4 cm²”. Dobutamine stress echocardiography confirmed true LF-LG AS, with increased SVi >20%, EF rising to approximately 60%, and a mean gradient of 40 mmHg, while AVA remained at 0.7 cm² (Fig. 1), BAV (bicuspid aortic valve), psychiatric illness, and a diagnosis of renal carcinoma. Following a multidisciplinary team discussion (cardiologists “imaging and interventional”, a cardiac surgeon, urologist, oncologist, and interventional radiologist), considering the patient’s frailty and various comorbidities, a decision was made to proceed with Transcatheter Aortic Valve Implantation (TAVI) and manage the renal tumor initially through endovascular embolization followed by microwave thermal ablation (Fig. 2-3). The patient first underwent TAVI, despite the presence of a BAV, with excellent results. Subsequently, the renal tumor was treated, achieving complete oncological success. Discussion: This case demonstrates the potential of minimally invasive approaches in interventional cardiology and radiology, yielding excellent therapeutic outcomes while minimizing risks in a patient with complex health conditions. Subsequent follow-up showed adequate cardiac compensation despite the patient's poor adherence to medication. Complete eradication of kidney cancer. This case underscores the effectiveness of a minimally invasive, multidisciplinary approach in managing complex comorbidities, such as valvular aortic stenosis and renal carcinoma. Despite the patient’s relatively young age and the presence of a BAV, TAVI was successfully performed, demonstrating the expanding role of transcatheter interventions even in complex anatomical variations. Our strategy allowed for safe and effective management of both cardiovascular and oncological conditions without resorting to more invasive surgical procedures, which would have carried higher risks given the patient’s frailty. Conclusion: This case report illustrates how collaboration among an expert team, can lead to optimal patient outcomes. The approach used here exemplifies the growing preference for interventional methods over traditional surgery, offering safer and more reliable options with reduced hospital stays and faster recovery times.