89+ year old patient presented with an NSTEMI & known severe | Figure 1

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89+ year old patient presented with an NSTEMI & known severe AS. Angio showed severe LM stenosis & in-stent restenosis of a previous LAD stent. Not suitable for further PCI, & too high risk for combined CABG/AVR. So combined off-pump CABG + TAVI allowed procedure to be performed without cardiopulmonary bypass. The 3D recon shows the LIMA-LAD & radial T graft to OM + the TAVI prosthesis. The aortogram shows good functioning prosthesis.

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