Repeated transapical TAVI for the treatment of a degenerated bioprosthetic valve

We present a case of a failing trancatheter aortic valve treated with a repeated transapical (TA) TAVI valve in valve (ViV) procedure. Important considerations that need to be addressed carefully, is the correct choice of the second valve size and the implantation height. All available imaging modalities such as CT, TOE and aortogram are important to assess the mechanism of the valve degeneration and for the planning of the ViV procedure, in order to have a successful result.