Transcatheter Balloon-Expandable Valve-in-Valve to Treat Severe Paravalvular Leak Secondary to Acurate-neo Self-expanding Prosthesis-Annulus Mismatch

Abstract A 75-year-old male with severe symptomatic aortic stenosis underwent transcatheter aortic valve implantation (TAVI) with a Large -size (27-mm) ACURATE- neo valve complicated by severe paravalvular leak. He developed rapid and progressive worsening heart failure. Re-analysis of computer tomography suggested evidence of prosthesis-annulus mismatch. Therefore, a redo TAVI utilising a 29-mm SAPIEN 3 transcatheter aortic valve was performed. This case illustrates the importance of proper valve sizing to avoid paravalvular leak and also demonstrates how to safely cross an ACURATE- neo valve to avoid catheter entangling.