• Jiabing Huang, Pengfei Chen, Xinqun Hu, Jianjun Tang, and Zhenfei Fang.
• Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China.
• Medicine (Baltimore). 2018 Aug 1; 97 (33): e11900.

RationaleCardiogenic shock secondary to aortic stenosis (AS) is a challenging problem owing to the high mortality associated with treatment, and successful treatment of such patients has been rare.Patient ConcernsA 77-year-old man presented with exercise intolerance and progressive exertional dyspnea and chest pain. The patient was suffered from cardiogenic shock after percutaneous coronary intervention.DiagnosisHe was diagnosed by transthoracic echocardiography (TTE) and coronary angiogram. His main diagnose was AS and coronary artery disease.InterventionThe patient received venoarterial extracorporeal membrane oxygenation (VA-ECMO) and transcatheter aortic valve replacement (TAVR).OutcomeAs of the 5-month follow-up, the patient was well, and capable of basic independent living. The TTE suggested that the left ventricular end-diastolic volume had decreased from 66 to 45 mm and the left ventricular ejection fraction had risen from 20% to 50%.LessonsPatients with cardiogenic shock secondary to AS are very difficult to treat medically. ECMO with TAVR may be a reasonable strategy.

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