# TAVI in Complex Dual-Level Obstruction: A Case of Severe Aortic Stenosis and Subaortic Membrane

## TL;DR

This case study shows how TAVI can be successfully used in patients with both severe aortic stenosis and a subaortic membrane.

## Contribution

The study demonstrates TAVI's viability in complex dual-level obstruction cases where surgery is not an option.

## Key findings

- Multimodal imaging enabled successful TAVI in a high-risk patient with dual-level obstruction.
- TAVI is a viable alternative to surgery for patients with severe aortic stenosis and subaortic membrane.
- The approach avoids the need for open surgery in non-surgical candidates.

## Abstract

This case addresses the challenges of treating patients with both severe aortic stenosis and subaortic stenosis. In this combined condition, transcatheter aortic valve implantation (TAVI) remains an off-label application, particularly in the presence of a subaortic membrane.

Our multimodal imaging approach that incorporates echocardiography, cardiac computed tomography, and fluoroscopic guidance demonstrates the successful application of TAVI in a high-risk clinical scenario. The results underscore the potential of TAVI as a viable alternative to traditional surgical aortic valve replacement for patients with dual-level obstruction who are not candidates for open surgery.