{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:10:17Z","timestamp":1740103817802,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite progressively uncommon in Western countries, rheumatic heart disease still portrays a significant global burden. In elderly or high\u2010surgical risk patients, plurivalvular disease may require a complex percutaneous approach. Transcatheter aortic valve implantation (TAVI) in patients with previous monoleaflet mitral prosthesis is challenging due to interference between the aortic valve and the rigid mitral mechanical prosthesis \u201cring.\u201d\u00a0Prior cases report the use of CoreValve or Edwards Sapien aortic valves in patients with adequate mitro\u2010aortic distance. Performing a second major procedure, such as tricuspid valve\u2010in\u2010valve (TVIV), sequentially during a single percutaneous intervention, increases treatment complexity. An 83\u2010year\u2010old woman with rheumatic heart disease, with previous implantation of a Bjork\u2013Shiley monoleaflet mitral prosthesis, and Carpentier\u2010Edwards 29 tricuspid bioprosthesis presented with decompensated heart failure due to severe aortic stenosis and tricuspid bioprosthesis stenosis. After HeartTeam discussion, the patient was deemed as inoperable due to a prohibitive surgical risk. As an alternative, a TAVI (Navitor FlexNav) and a transcatheter TVIV replacement (Edwards Sapiens 3 Ultra) were discussed and proposed, with both techniques being performed sequentially in a single procedure. TAVI in a patient with a previous monoleaflet mitral mechanical prosthesis and TVIV may be a feasible approach in inoperable patients with plurivalvular disease.<\/jats:p>","DOI":"10.1002\/ccd.31057","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T09:14:50Z","timestamp":1713518090000},"page":"1159-1164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combined transcatheter aortic valve and tricuspid valve\u2010in\u2010valve implantation in a patient with a mitral mechanical prosthesis"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5039-320X","authenticated-orcid":false,"given":"Maria Rita","family":"Lima","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital de Santa Cruz Centro Hospitalar de Lisboa Ocidental Lisbon 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