Severe aortic stenosis and acute coronary syndrome in an elderly patient with idiopathic thrombocytopenic purpura:a therapeutic challenge

Severe valvular aortic stenosis is a commonly encountered disorder in the elderly,and the intervention is indicated when the pa-tient is symptomatic.Transcatheter aortic valve im-plantation(TAVI)is a safer therapeutic option in symptomatic patients who cannot undergo surgery or who have high,intermediate,or even low surgic-al risk.[1]Idiopathic thrombocytopenic purpura(ITP)is acquired thrombocytopenia caused by autoan-tibodies against platelet antigens.[2]Herein,we re-port an 81-year-old patient,who was diagnosed with primary ITP two years ago,was admitted to the hospital for heart failure with acute coronary syndrome and severe aortic stenosis.We describe our experience in the peri-operative management of the case of coronary and structural intervention in a patient with ITP.