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 method, especially in patients with aortic stenosis whose surgical risk score is moderate to high. One of the possible complications after TAVI is bradyarrhythmia resulting from high-grade atrioventricular block. Some patients in this situation may require permanent pacemaker (PM) implantation. In this case, we presented a case with symptomatic intermittent pauses and severe aortic stenosis, who underwent permanent PM implantation through the coronary sinus before TAVI due to a history of mechanical tricuspid and mitral valve replacement, and subsequently underwent successful TAVI. The patient remained stable with no periprocedural complications.