There are a significant number of symptomatic aortic stenosis (AS) patients not referred to the traditional methods for some complexity conditions. We described a case of a 61-year-old female with severe symptomatic AS, calcific small aortic annulus (16.6 mm), narrow porcelain ascending aorta (aortic root 14.6 mm, internal diameter 14.0 mm), chronic renal insufficiency and a history of previous sternotomy for mechanical mitral valve replacement (MVR) and coronary artery bypass grafting (CABG) who underwent aortic valve bypass (AVB) with favorable results. AVB has been proposed as a complementary to surgery operation of aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) in high-risk AS patients.
