Transcatheter aortic valve replacement using the two-step inflation technique and the kissing-balloon technique for a patient with a protruding stent in the left main coronary artery: a case report.

Background: When performing transcatheter aortic valve replacement (TAVR) for a patient with a protruding stent in the coronary arteries, there is a risk of stent deformation and coronary occlusion. However, safe and optimal methods have not been established. Case summary: An 87-year-old woman with a protruding stent in the left main coronary artery (LMCA) underwent TAVR. The two-step inflation and kissing-balloon techniques were performed to optimize the transcatheter heart valve (THV) and to avoid LMCA stent deformation. The THV was implemented with minimal aortic regurgitation and no deformation of the stent in the LMCA. Discussion: This was the first case report of TAVR, performed in a patient with a protruding stent in the coronary arteries, using the kissing-balloon technique and the two-step inflation technique. The combination of these two techniques was the optimal method for THV implantation without stent deformation in coronary arteries.