Valve-in-Valve Transcatheter Aortic Valve Implantation of an Evolut R in a Degenerated Lotus Valve

Abstract

Degeneration of bioprosthesis also occurs in transcatheter aortic valve implantation. Treatment option in severe bioprosthetic failure is either surgical aortic valve replacement or transcatheter valve-in-valve implantation. Information about feasibility and outcome of the latter interventions is sparse. was to an A gradient of 27/18mmHg was measured at discharge. she represented with Echocardiography revealed a degenerated TAVI-bioprosthesis with an orifice area of 0.8cm² and a Pmax/mean of 90/50mmHg. to the restricted condition and comorbidities of this patient (logistic EuroSCORE I 32.75%) a valve-in-valve procedure was discussed. Meticulous planning including coronary angiography and CT-scan revealed an inner valve diameter of 18mm, a height of 20mm,