Dieulafoy’s Lesion in an Octogenarian Man with Severe Calcific Aortic Valve Stenosis, Severe Right Coronary Artery Stenosis, and a Very Large Abdominal Aortic Aneurysm

Abstract This is a case report of a Dieulafoy’s lesion in an octogenarian patient with recent diagnosis of severe aortic valve stenosis, severe stenosis of the right coronary artery and large abdominal aortic aneurysm. He has past history of myasthenia gravis, type 2 diabetes, hypertension, atrial fibrillation requiring long term anticoagulation, and chronic kidney disease. The medical challenges and prioritization of the current new problems formulate a prioritization of the medical management. The natural history of Dieulafoy’s lesion made it difficult to diagnose the source of bleeding. The patient underwent successful endovascular aneurysm repair (EVAR) followed by hemoclip of Dieulafoy’s lesion After two weeks of EVAR. Two months later underwent successful surgical aortic valve replacement with coronary bypass surgery to the right coronary artery. This case underscores the challenges posed by multiple comorbidities in elderly patients and the critical need for comprehensive, patient-centered care. The report serves as a reminder of the necessity for persistence in addressing diagnostic dilemmas and the potential for positive outcomes through collaborative care.