CASE REPORT article
Front. Cardiovasc. Med.
Sec. Heart Valve Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1515954
Case report of optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation
Provisionally accepted
- Hainan General Hospital, Haikou, China
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Left ventricular (LV) guidewire pacing has been proven to be a safe and effective pacing mode for transcatheter aortic valve replacement (TAVR). However, the high pacing voltage threshold and impedance of LV guidewire pacing are potential risks for loss of capture and valve embolization. Moreover, decisions surrounding whether and when to perform percutaneous coronary intervention (PCI) are always heterogeneous in patients with severe aortic stenosis and coronary artery disease. As described in this case report, we attempted an optimized LV guidewire pacing mode with the lowest pacing voltage threshold and impedance, avoiding complications associated with additional vascular access and further reducing TAVR costs. Additionally, we successfully performed simultaneous PCI in this patient with a vertically downward orifice of the right coronary artery (RCA), severe calcified stenosis in the RCA, horizocardia, and a dilated ascending aorta. This case report provides new evidence for LV guidewire pacing and the opportunity for PCI in TAVR procedures.
Keywords: Aortic Valve Stenosis, Coronary Artery Disease, Optimized left ventricular guidewire pacing, Transcatheter aortic valve replacement, Percutaneous Coronary Intervention
Received: 23 Oct 2024; Accepted: 07 Jul 2025.
Copyright: © 2025 Ma, Liao, Zhang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ruisong Ma, Hainan General Hospital, Haikou, China
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