Transcatheter Valve-in-Valve implantation after late migration of balloon expandable Sapien- XT prosthesis in a severe pure aortic regurgitation case

Transcatheter aortic valve implantation (TAVI) is an off label therapy in patients with severe, symptomatic, native aortic regurgitation (NAR) and porcelain aorta. Prosthetic valve migration (PVM) after TAVI occur with an incidence of 1.3% per patient-year. The Valve-in-Valve (TV-in-TV) implantation in an overlapping fashion is used as a rescue therapy to avoid cardiac surgery due to valve-malapposition. We report a PVM occurring late, i.e., 7 days after TAVI treated with a second valve implantation via transfemoral approach.