A meta-analysis of three randomized trials involving 1,156 patients with severe aortic stenosis and coronary disease reveals that performing percutaneous coronary intervention (PCI) before transcatheter aortic valve replacement (TAVR) fails to reduce death rates but nearly doubles bleeding complications. While PCI reduced urgent revascularization needs by 67% and showed borderline stroke reduction, major bleeding increased 88% compared to deferred intervention approaches. This finding challenges current clinical practice patterns where many cardiologists routinely address coronary blockages before valve procedures. The data suggests a more nuanced, patient-specific approach may be optimal rather than blanket pre-procedural coronary stenting. For patients facing combined heart valve and artery disease, this analysis indicates that the bleeding risks of upfront coronary intervention may outweigh benefits for many individuals. However, as an unreviewed preprint, these conclusions require validation through peer review and may be refined based on expert scrutiny. The work represents an incremental but clinically relevant contribution to cardiovascular decision-making, particularly for older adults who comprise the majority of TAVR candidates and face elevated bleeding risks.