title: First Reported Successful Femoral Valve-in-Valve Transcatheter Aortic Valve Replacement Using the Edwards Sapien 3 Valve.
abstract: OBJECTIVE
  Management of degenerated aortic valve bioprosthesis classically requires redo surgery, but transcatheter aortic valve-in-valve implantation is becoming a valid alternative in selected cases. In the case of a degenerated Mitroflow bioprosthesis, TAVR is associated with an additional challenge due to a specific risk of coronary occlusion. We aimed to assess the safety and feasibility of transfemoral valve-in-valve implantation of the new Edwards Sapien 3 (Edwards Lifesciences) in a degenerated Mitroflow bioprosthesis (Sorin Group, Inc).
  
  
  METHODS
  We report here the safety and feasibility of transfemoral valve-in-valve implantation of a 23 mm Edwards Sapien 3 in a degenerated 25 mm Mitroflow valve and describe the specific assessment of the risk of coronary obstruction using a multi-imaging modality.
  
  
  RESULTS
  The final result showed an absence of aortic regurgitation and a mean transvalvular gradient of 14 mm Hg. The patient had no major adverse cardiovascular events at 30-day follow-up.
  
  
  CONCLUSIONS
  Transcatheter valve-in-valve implantation of an Edwards Sapien 3 in a degenerated Mitroflow is feasible and safe, considering a careful assessment of the risk of coronary obstruction with Mitroflow bioprosthesis due to leaflets mounted externally to the stent.
authors.forename: Stephane
authors.initials: S
authors.lastname: Fournier
authors.forename: Pierre
authors.initials: P
authors.lastname: Monney
authors.forename: Christan
authors.initials: C
authors.lastname: Roguelov
authors.forename: Andrea
authors.initials: A
authors.lastname: Zuffi
authors.forename: Juan F
authors.initials: JF
authors.lastname: Iglesias
authors.forename: Salah D
authors.initials: SD
authors.lastname: Qanadli
authors.forename: Cecile
authors.initials: C
authors.lastname: Courbon
authors.forename: Eric
authors.initials: E
authors.lastname: Eeckhout
authors.affiliation: Service de cardiologie, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Olivier.Muller@chuv.ch.
authors.forename: Olivier
authors.initials: O
authors.lastname: Muller
mesh_terms: D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis; D017548:Echocardiography, Transesophageal; D005260:Female; D005263:Femoral Artery; D006350:Heart Valve Prosthesis; D006801:Humans; D011474:Prosthesis Design; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*