Introduction: Aortic stenosis is one of the most com-mon and most serious valve disease problems. Aortic stenosis is a narrowing of the aortic valve opening. Aortic stenosis restricts the blood flow from the left ventricle to the aorta and may also affect the pressure in the left atrium.

Methods: We would like to presents a case of a male pa-tient of 65 years old, ex-smoker, known with hyperten-sion, who was examined accusing heart failure signs, with dyspnea to progressively smaller efforts, periphe-ric edema. We performed an echocardiography which revealed tight aortic stenosis with operator indication, but he had reduced ejection fraction. The patient was coronary angiographic evaluated and revealed diffuse atheromatous impregnation, with significant stenosis on ADA.

Results: Due to poor left ventricular performance and associated coronary and valvular pathology, it was de-cided to use a hybrid treatment for the patient. Thus, after coronary angioplasty with implantation of three DES on LAD, the patient benefited of transcatheter aortic valve implantation. Postoperative outcome was favorable, with the significant improvement in heart fa-ilure phenomena and quality of life.

Conclusions: From this case is important to draw the conclusion that in a patient with a lot of comorbidities – heart failure with reduced ejection fraction, tight aor-tic stenosis, significant coronary stenosis, the hybrid therapy with coronary angioplasty and transcatheter aortic valve implantation is a very useful solution.