Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPFREIRE, A. F. D.FILIPPINI, F. B.BIGNOTO, T. C.BRITO, P. H. F. deNICZ, P. F. G.MELO, P. H. M. C. D.SILVA, R. C. eQUEIROGA, M.RIBEIRO, H. B.PROCóPIO, A. G. M.BEZERRA, C. G.GRUBE, E.ABIZAID, A.FILHO, R. K.BRITO JR., F. S. de2024-03-132024-03-132022JOURNAL OF CARDIOLOGY CASES, v.26, n.3, p.181-185, 20221878-5409https://observatorio.fm.usp.br/handle/OPI/58713Patients presenting with aortic stenosis and atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR) are commonly at increased risk for stroke and bleeding complications. Concomitant left atrial appendage occlusion (LAAO) after TAVR may be an alternative to oral anticoagulation (OAC). Between 2018 and 2022, 7 consecutive patients who were ineligible for OAC underwent simultaneous TAVR and LAAO. The mean age was 84.9 ± 4.9 years. The mean CHA2DS2-VASc, HAS-BLED, and STS predicted risk of mortality scores were 5.9 ± 0.7, 3.9 ± 1.1, and 8.8 ± 3.4%, respectively. The median follow-up time was 23 (1 to 27) months. All procedures achieved technical success and no adverse events were observed during follow-up. This case series shows that concomitant TAVR and LAAO is feasible and safe among patients with severe aortic stenosis and AF who are deemed ineligible for OAC. Learning objectives: Atrial fibrillation is the most common arrhythmia in the transcatheter aortic valve replacement (TAVR) population. In those who experience major or life-threatening bleeding, mortality is doubled. We report a case series of 7 concomitant left atrial appendage occlusions (LAAO) after TAVR in patients ineligible for oral anticoagulation. All procedures achieved technical success and no adverse events were observed. The simultaneous approach with TAVR and LAAO was feasible and safe in this case series.engrestrictedAccessAnticoagulationAntiplateletAortic valveAtrial fibrillationStenosisThrombusValve replacementacetylsalicylic acidanticoagulant agentclopidogrelabsence of complicationsagedanticoagulant therapyaortic stenosisargon plasma coagulationarticleatrial fibrillationbicuspid aortic valvebrain hemorrhagecase reportcase studycha2ds2-vasc scoreclinical articlecomputer assisted tomographyconservative treatmentdrug contraindicationdual antiplatelet therapyfaintnessfall riskfeasibility studyfemalefollow upfrailtyfunctional diseasegastrointestinal hemorrhagehas bled scoreheart failureheart left atriumheart left ventricle ejection fractionheart left ventricle failurehigh risk patienthumanleft atrial appendage closuremalemonotherapymortality risknew york heart association classpatient safetyrandomized controlled trial (topic)rectum hemorrhagesociety of thoracic surgeons scoresubdural hematomatranscatheter aortic valve implantationtransesophageal echocardiographyvery elderlyarticleCopyright ELSEVIER LTD10.1016/j.jccase.2022.04.008