Patient with hypertension, diabetes, COPD (chronic obstructive pulmonary disease) and chronic kidney disease, was referred to a cardiologist examination because of aortic stenosis progression. In 2002 he underwent triple coronary artery bypass surgery. By transthoracic echocardiography severe aortic stenosis was confirmed with maximum gradient around 95 mmHg, and AVA (aortic valve area) 0.7 cm². Two passable bypasses were verified by coronography, while bypass on OM1 was ostially subocluded, so a stent had to be implanted. Because of the risk of resternotomy, severe COPD and numerous comorbidities, cardiosurgical operation was not an option, so transcatheter aortic valve implantation (TAVI) became viable option. (1) By transesophageal echocardiography (TEE) we have verified thrombus in the area of descending aorta, specifically microsomatic substance that delayed the procedure. By MSCT aortography we have found aneurysmal widening of the abdominal aorta with diameter of 2.5 cm. During the next hospitalization he was reprocessed by angiography of aortoiliac blood vessels, which by morphology and dimensions were supporting the possibility of percutaneous implantation of aortic valve, also TEE which does not show earlier described intraluminal formation in the aorta. TAVI procedure was done by transcarotid approach because of impossibility of transfemoral approach and because of increased transaortic risk because of severe COPD. Just before the procedure, MSCT angiography of carotid arteries was done which contributed to postintervention complication of contrast-induced nephropathy. The procedure of aortic valve implantation went without complication with minimal paravalvular insufficiency. Soon after the procedure patient developed anuria, which required dialysis after which kidney function was restored to normal. By medical telemetry we spotted ectopic ventricular activity with short term episodes of ventricular tachycardia, so amiodarone was introduced into therapy. Regular echocardiography ultrasound showed normal function of CoreValve, and maximum systolic gradient was 13 mmHg. Patient was discharged home in generally good condition and normalized laboratory values.