title: Transapical aortic valve-in-valve-in-valve implantation as a procedural rescue option.
abstract: Device malposition and dysfunction with resultant severe aortic insufficiency are known complications of transcatheter aortic valve implantation (TAVI). Fortunately, these complications can often be successfully treated with a transcatheter valve-in-valve (VinV) implantation. However, prosthetic leaflet dysfunction or immobility from the VinV configuration can lead to severe central aortic insufficiency. We report the first known case of implantation of a third SAPIEN prosthesis (Edwards Lifesciences, Irvine, CA) during TAVI as a valuable bailout strategy to deal with severe aortic insufficiency after VinV implantation.
authors.affiliation: Department of Cardiac Surgery, Kerkhoff Clinic, Bad Nauheim, Germany. kempfertj@googlemail.com
authors.forename: Joerg
authors.initials: J
authors.lastname: Kempfert
authors.forename: Felix
authors.initials: F
authors.lastname: Girrbach
authors.forename: Martin
authors.initials: M
authors.lastname: Haensig
authors.forename: Sreekumar
authors.initials: S
authors.lastname: Subramanian
authors.forename: David Michael
authors.initials: DM
authors.lastname: Holzhey
authors.forename: Friedrich Wilhelm
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D006328:Cardiac Catheterization; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation