Patients with severe aortic stenosis (AS) and indication to complex percutaneous coronary intervention (ASCoP) pose technical challenges, and a possible therapeutic algorithm has been proposed recently.1 In this paper, we present the 1-year three-dimensional computed-tomography follow-up of a 78-year-old patient with multiple risk factors admitted for unstable angina and dyspnoea at minimal efforts in the context of severe AS and critical calcific stenosis involving distal left main (LM) and the ostium of a dominant left circumflex.