ViViV TAVR for Severe Symptomatic Aortic Stenosis in a Degenerated Prior TAVR ViV: A Case Report

Case Report

Volume 6, Issue 3

ViViV TAVR for Severe Symptomatic Aortic Stenosis in a Degenerated Prior TAVR ViV: A Case Report

Abhinandan Singla^*, Amritpal Singh, Vijay Kumar Doddapaneni, Guneet Ahluwalia, Daniel DiBardino and Muhammad Ali Zulqarnain

Mercy St Vincent Medical Center, USA

^*Corresponding author: Abhinandan Singla, Department of Internal Medicine, Mercy St Vincent Medical Center, USA. E-mail: abhinandansingla344@gmail.com

Received: May 01, 2026; Accepted: May 22, 2026; Published: June 05, 2026

Citation: Singla A, Singh A, Doddapaneni VK, et al. ViViV TAVR for Severe Symptomatic Aortic Stenosis in a Degenerated Prior TAVR ViV: A Case Report. Case Rep Clin Cardiol J. 2026; 6(3): 184.

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Abstract

Background: Valve-in-valve-in-valve (ViViV) TAVR is rarely documented.
Case: An 81-year-old woman with a prior 19 mm Trifecta surgical bioprosthesis and 20 mm Sapien 3 Ultra ViV TAVR (2023) presented with severe recurrent aortic valve-in-valve stenosis. Heart-team evaluation deemed repeat surgery prohibitive. She underwent transfemoral ViViV TAVR with a 23 mm Evolut FX+. Post-procedural echocardiography demonstrated an AVA of 3.2 cm², invasive gradient of 6 mmHg, and trace paravalvular regurgitation. The patient was discharged without complications.
Conclusion: ViViV TAVR is feasible in selected patients with small surgical bioprostheses, yielding excellent hemodynamic outcomes with careful planning and device selection.

Keywords: ViViV TAVR; Valve-in-valve; Bioprosthetic valve failure; Redo TAVR; Evolut FX+; Small annulus

Article Details

ViViV TAVR for Severe Symptomatic Aortic Stenosis in a Degenerated Prior TAVR ViV: A Case Report