Expanded Evidence on the Simultaneous Performance of Transcatheter Aortic Valve Implantation (TAVI) and Endovascular Abdominal Aortic Aneurysm Repair (EVAR): Literature Review and Case Report

The synchronous occurrence of aortic valve stenosis (AS) and abdominal aortic aneurysm (AAA) is becoming increasingly common, largely due to rising life expectancy. There are no clear recommendations or consensus regarding the optimal treatment sequence. However, the development of minimally invasive techniques—transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR)—has reshaped the therapeutic landscape, enabling treatment of both conditions either simultaneously (same day) or in staged procedures (different days). This study aims to expand the available evidence on the simultaneous treatment of AS and AAA. A literature review (2011–2016), conducted according to PRISMA criteria, identified 25 publications encompassing 337 patients. The review examines: a) the benefits and advantages of the simultaneous strategy compared with staged treatment, and b) the optimal first procedure within the simultaneous approach. The case of an asymptomatic patient with a large AAA (11.5 cm maximal transverse diameter) and severe AS is also presented, treated simultaneously with TAVI followed by EVAR, achieving a satisfactory outcome, with long‑term follow‑up available. Conclusion: Simultaneous treatment of both conditions is feasible, effective, and safe when supported by detailed preoperative planning and a multidisciplinary team capable of determining the optimal procedural sequence. Based on the available evidence, the simultaneous approach has evolved from an option reserved for selected patients to the preferred strategy in most cases.