A 78-year-old female patient was admitted to West China Hospital of Sichuan University because of “amaurosis and polypnea for 4+ years”. The examination results before admission showed that severe stenosis of aortic valve, bicuspid aortic valve malformation, severe horizontal heart with 61.54° aortic angle. The preoperative evaluation of the patient indicated that the Society of Thoracic Surgeons score was 17.9%, which was high risk for surgery. After discussion by the heart team, the aortic stenosis was finally relieved by transcatheter aortic valve replacement. The operation was successfully completed by using the method of pulling and releasing the device with the same side basket. One month follow-up showed that the patient’s condition was stable and no complications occurred. This case aims to provide a reference for the treatment of horizontal heart with aortic stenosis. In the future, it is hoped that through continuous clinical practice, such patients will be provided with a safer and more efficient treatment plan.