78 year-old-male presented on August 7, 2020 with progressive exertional dyspnea, NYHA class III. Workup revealed severe AS (AVA 0.7cm2), normal LV function and STS mortality of 1.1%. After heart team discussion, patient underwent successful TAVR using 26mm SAPIEN-3 Ultra with excellent results, AV area of 2.0cm2 and no PVL. A coronary angiography pre-TAVR procedure revealed severe calcific 2 V CAD of LAD (iFR 0.79) and RPDA with SYNTAX score of 22. Patient continued to have mild DOE and chest pressure likely due to anatomically & physiologically significant CAD of LAD lesion and possibly RPDA lesion. Now planned post TAVR, for imaging guided orbital atherectomy of long calcified LAD using trans-radial access.