{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:47:51Z","timestamp":1754488071862,"version":"3.37.3"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T00:00:00Z","timestamp":1603497600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Onassis Cardiac Surgery Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Valve-in-valve transcatheter aortic valve implantation (TAVI) has emerged as a competent alternative for the treatment of degenerated bioprosthetic valves after surgical aortic valve replacement, or during TAVI procedure as a bailout option. Herein, we report a rare case of a self-expandable Medtronic Evolut R valve into a failing Medtronic CoreValve, with the use of modern pre-TAVI imaging screening, suggesting the proper procedural design steps for so complicated implantations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A frail 78-year-old woman with a degenerated Medtronic Core Valve 26\u2009mm bioprosthesis, implanted in 2011 due to severe aortic stenosis, was referred to our hospital due to worsening dyspnoea New York Heart Association III. The screening echocardiography documented severe aortic stenosis, while the classical risk scores were in favour of repeated TAVI (EuroSCORE II 5.67%). Computed tomography measurements and three-dimensional (3D) printing model were of great help for the proper valve selection (Medtronic Evolut R 26\u2009mm), while the use of cerebral protection device (Claret Sentinel) was considered as a necessary part of the procedure. The simultaneous use of fluoroscopy and transoesophageal echocardiogram led to optimal haemodynamic result, confirmed by the discharge echocardiogram, with a significant clinical improvement during the first month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The main periprocedural concerns remain valve malpositioning, coronary artery obstruction, and high remaining transvalvular gradients. The multimodality pre-TAVI imaging screening may be helpful for precise procedural design. Despite the limited use of 3D models, it is necessary to adopt such tissue-mimicking phantoms to increase the possibility of optimal procedural result.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa256","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T02:40:49Z","timestamp":1603507249000},"page":"1-6","source":"Crossref","is-referenced-by-count":3,"title":["Repeated transcatheter aortic valve implantation for the treatment of a degenerated transcatheter aortic valve implantation valve (valve-in-valve technique): a case report"],"prefix":"10.1093","volume":"4","author":[{"given":"Vassileios","family":"Voudris","sequence":"first","affiliation":[{"name":"Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Iakovou","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6157-3222","authenticated-orcid":false,"given":"Ilias","family":"Kosmas","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eftychia","family":"Sbarouni","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou av, 176 74 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"2021010812211260900_ytaa256-B1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.hjc.2019.03.009","article-title":"Is TAVR going to be our default choice for treating aortic valve stenosis?","volume":"60","author":"Kanakakis","year":"2019","journal-title":"Hellenic J Cardiol"},{"key":"2021010812211260900_ytaa256-B2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.hjc.2017.06.004","article-title":"Repeated transapical TAVI for the treatment of a degenerated bioprosthetic valve","volume":"59","author":"Eftychiou","year":"2018","journal-title":"Hellenic J Cardiol"},{"key":"2021010812211260900_ytaa256-B3","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1080\/14779072.2019.1704624","article-title":"Developments in transcatheter aortic bioprosthesis durability","volume":"17","author":"Petronio","year":"2019","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2021010812211260900_ytaa256-B4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1080\/14779072.2019.1703673","article-title":"Early detection of transcatheter heart valve dysfunction","volume":"17","author":"Valvo","year":"2019","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2021010812211260900_ytaa256-B5","article-title":"\u201cTAVI: Valve in Valve. A new field for structuralists? Literature review\u201d","author":"Vrachatis","year":"2019","journal-title":"Hellenic J Cardiol"},{"key":"2021010812211260900_ytaa256-B6","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.jcmg.2019.06.025","article-title":"Coronary access after repeated transcatheter aortic valve implantation: a glimpse into the future","volume":"13","author":"Buzzatti","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021010812211260900_ytaa256-B7","article-title":"Transcatheter aortic valve implantation using 3-D printing modeling assistance. A single-center experience","author":"Bompotis","year":"2019","journal-title":"Hellenic J Cardiol"},{"key":"2021010812211260900_ytaa256-B8","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.amjcard.2019.11.015","article-title":"Computed tomography features of cuspal thrombosis and subvalvular tissue ingrowth after transcatheter aortic valve implantation","volume":"125","author":"Koo","year":"2019","journal-title":"Am J Cardiol"},{"key":"2021010812211260900_ytaa256-B9","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1093\/eurheartj\/ehy847","article-title":"Rate of peri-procedural stroke observed with cerebral embolic protection during transcatheter aortic valve replacement: a patient-level propensity-matched analysis","volume":"40","author":"Seeger","year":"2019","journal-title":"Eur Heart J"},{"key":"2021010812211260900_ytaa256-B10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.hjc.2017.09.013","article-title":"Multi-slice CT (MSCT) imaging in pretrans-catheter aortic valve implantation (TAVI) screening. How to perform and how to interpret","volume":"59","author":"Latsios","year":"2018","journal-title":"Hellenic J Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/6\/1\/35544697\/ytaa256.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/6\/1\/35544697\/ytaa256.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T23:52:14Z","timestamp":1610581934000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/6\/1\/5937246"}},"subtitle":[],"editor":[{"given":"Julien","family":"Adjedj","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Chiara De","family":"Biase","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Romain","family":"Didier","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,10,23]]},"references-count":10,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,10,23]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa256","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,10,23]]}}}