Management of Bradycardia Before Transcatheter Aortic Valve Implantation in a Patient with Mechanical Tricuspid and Mitral Valve Replacement

Transcatheter aortic valve implantation (TAVI) has proven to be a safe and effective treatment, particularly in patients with aortic stenosis and moderate to high surgical risk scores. One potential complication after TAVI is bradyarrhythmia due to high-grade atrioventricular block, which may necessitate permanent pacemaker (PM) implantation. We present a case of a patient with symptomatic intermittent pauses and severe aortic stenosis who underwent permanent PM implantation via the coronary sinus prior to TAVI, due to a history of mechanical tricuspid and mitral valve replacements. The subsequent TAVI procedure was successful, and the patient remained stable without periprocedural complications.

Keywords: Aortic stenosis, pacemaker, valve disease