{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:33:57Z","timestamp":1784111637517,"version":"3.55.0"},"reference-count":15,"publisher":"BMJ","issue":"7","funder":[{"name":"Fonds Scientifique Cardiovasculaire, Fribourg","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,10]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>In the case of the degeneration of surgical aortic valve replacement (SAVR), the transcatheter aortic valve implantation (TAVI) has become the standard. However, these valves are also susceptible to deterioration. In such instances, a new TAVI implantation may be considered. We present the case of a patient with a SAVR who underwent two TAVI procedures, spaced 8 years apart. We discuss important practical aspects, including the risk of coronary obstruction and the final valve diameter.<\/jats:p>","DOI":"10.1136\/bcr-2024-260437","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T22:10:19Z","timestamp":1721772619000},"page":"e260437","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Valve-in-Valve-in-Valve"],"prefix":"10.1136","volume":"17","author":[{"given":"Selma Tosca","family":"Cook","sequence":"first","affiliation":[{"name":"Cardiology, University of Fribourg, Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Togni","sequence":"additional","affiliation":[{"name":"Cardiology, University of Fribourg, Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Denervaud","sequence":"additional","affiliation":[{"name":"Cardiology, University of Fribourg, Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8337-4053","authenticated-orcid":false,"given":"Stephane","family":"Cook","sequence":"additional","affiliation":[{"name":"Cardiology, University of Fribourg, Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"2025082623405594000_17.7.e260437.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002003"},{"key":"2025082623405594000_17.7.e260437.2","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.116.003930","article-title":"Outcomes of redo transcatheter aortic valve replacement for the treatment of postprocedural and late occurrence of paravalvular regurgitation and transcatheter valve failure","volume":"9","author":"Barbanti","year":"2016","journal-title":"Circ Cardiovasc Interv"},{"key":"2025082623405594000_17.7.e260437.3","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.jaccas.2019.08.020","article-title":"Valve in valve in valve","volume":"1","author":"Grondahl","year":"2019","journal-title":"JACC Case Rep"},{"key":"2025082623405594000_17.7.e260437.4","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.carrev.2020.07.002","article-title":"Rescue valve-in-valve-in-valve TAVR for acute transvalvular aortic regurgitation","volume":"21","author":"Malik","year":"2020","journal-title":"Cardiovasc Revasc Med"},{"key":"2025082623405594000_17.7.e260437.5","doi-asserted-by":"crossref","first-page":"2933","DOI":"10.1016\/S0735-1097(22)03924-9","article-title":"A rare case of valve-in-valve-in-valve transcatheter aortic valve replacement","volume":"79","author":"Kumar","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025082623405594000_17.7.e260437.6","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.5422","article-title":"Matryoshka procedure for valve-in-valve TAVI failure","volume":"10","author":"Lodo","year":"2022","journal-title":"Clin Case Rep"},{"key":"2025082623405594000_17.7.e260437.7","doi-asserted-by":"crossref","first-page":"S180","DOI":"10.1016\/j.carrev.2022.04.015","article-title":"A case of valve-in-valve-in-valve for severe aortic regurgitation: is lifetime management upon us?","volume":"53S","author":"Paz Rios","year":"2023","journal-title":"Cardiovasc Revasc Med"},{"key":"2025082623405594000_17.7.e260437.8","doi-asserted-by":"crossref","first-page":"2869","DOI":"10.1016\/S0735-1097(23)03313-2","article-title":"TAVI-in-TAVI-in-SAVR in a patient with C. 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