TAVI-in-TAVI-in-Valve in a Patient with 2 consecutive valves degeneration - The 72nd Annual Conference of the Israel Heart Society in association with the Israel Society of Cardiothoracic Surgery

Ibrahim Magdoub ¹ Yair Feld ² Uri Landes ¹

¹Cardiology Department, Bnai Zion Medical Center, Technion - Israel Institute of Technology Haifa, Israel, Israel
²Cardiology Department, Baruch Padeh Medical Center, Faculty of Medicine in the Galilee - Bar Ilan University Poriya, Israel, Israel

This report describes a case of a 76-year-old female patient who underwent surgical aortic- valve replacement (SAVR) with a Perceval S (19-21). Four years later, due to degeneration of the Perceval (severe stenosis and significant paravalvular leak (PVL)), she was treated with valve-in-valve (ViV) TAVI with a 26mm Evolut Pro valve.

Two years later, she developed heart failure symptoms secondary to significant stenosis and severe PVL. After valve thrombosis and endocarditis was ruled out, it was decided to proceed with a repeat TAVI. This procedure was performed successfully using a 23 mm Sapien 3 Ultra valve which successfully tackled both stenotic leaflets and the PVL.

This case labels several issues and challenges along the modern day lifelong gurney of AS patients.