How should I treat a patient with severe and symptomatic aortic stenosis who is rejected for surgical and transfemoral valve replacement and in whom a transapical implantation was aborted?

Background: A 74 year old male with a history of postero-lateral myocardial infarction in 1993 and coronary bypass surgery in 1994 was referred to the outpatient clinic in a frail general condition with signs of dyspnoea at rest. Investigations: Physical examination, electrocardiography, laboratory tests, coronary angiography, abdominal angiography, Echo-doppler, transesophageal echo. Diagnosis: Aortic stenosis. Management: Valve replacement.