Valve-in-Valve for the Treatment of Paravalvular Leaks Following Transcatheter Aortic Valve Implantation

Transcatheter aortic valve implantation (TAVI) is commonly associated with some degree of aortic regurgitation (AR) secondary to the presence of paravalvular leaks. We present the case of an 86-year-old woman diagnosed with severe aortic stenosis who underwent TAVI with a 23-mm Edwards-SAPIEN valve. The procedure complicated with a severe paravalvular leak following TAVI that was unresponsive to balloon postdilation. This complication was successfully managed with the implantation of a second valve of the same diameter within the first one (valve-in-valve) resulting in trivial residual AR and the absence of significant transvalvular gradient at the end of the procedure. (C) 2009 Wiley-Liss, Inc.