Complete atrioventricular block during thoracic endovascular aortic repair

Acute coronary syndrome (ACS) and acute aortic syndrome (AAS) are both life-threatening emergencies. We report a case of ACS with thoracic aneurysm. Thoracic endovascular aortic repair (TEVAR) was arranged. However, perioperative complete atrioventricular block occurred and soon progressed to ST-elevation myocardial infarction. In the case of chest discomfort with elevated troponin I and thoracic aneurysm, it is of tremendous importance to cope with both ACS and the possible AAS. In the era of hybrid operation room, coronary catheterization and intervention first followed by TEVAR may provide timely and more comprehensive treatment.