Why the study?
As TAVI expands, repeated transcatheter valve implantations are increasingly needed but carry heightened risks of complications such as patient-prosthesis mismatch, impaired coronary access, and aortic regurgitation.
Does implantation of a self-expanding supra-annular valve in a valve-in-valve-in-valve configuration improve severe transvalvular regurgitation in a patient with failed balloon-expandable transcatheter valves?
Comparison
Self-expanding supra-annular valve implantation in a valve-in-valve-in-valve configuration
Design
Case report
Key result
Implantation of a self-expanding supra-annular prosthesis in a valve-in-valve-in-valve configuration successfully restored valve competence and improved functional status to NYHA class I at 18 months.
Authors
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May warrant consideration in complex redo TAVI with failed balloon-expandable valves; extends options but remains hypothesis-generating.
Case Report (n=1)
No
Does implantation of a self-expanding supra-annular valve in a valve-in-valve-in-valve configuration improve severe transvalvular regurgitation in a patient with failed balloon-expandable transcatheter valves?
Switching from a balloon-expandable to a self-expanding supra-annular valve in a valve-in-valve-in-valve configuration is a feasible and effective strategy to correct severe transvalvular regurgitation in complex redo TAVI procedures.
Emini et al. (2026) conducted a case report in Severe aortic prosthesis dysfunction with severe transvalvular regurgitation (n=1). Self-expanding supra-annular transcatheter heart valve (Valve-in-Valve-in-Valve configuration) was evaluated on Restoration of valve competence and clinical improvement. Implantation of a self-expanding supra-annular prosthesis in a valve-in-valve-in-valve configuration successfully restored valve competence and improved functional status to NYHA class I at 18 months.