Severe structural deterioration of small aortic bioprostheses treated with valve-in-valve transcatheter aortic valve implantation.

Transfemoral VIV-TAVI in patients with small, degenerated bioprostheses appears to be a promising alternative to surgery. Although the vast majority of patients have significant improvement in their NYHA class, the rate of persistent, residual gradients is relatively high and will need to be followed closely with serial echocardiograms.