{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T08:08:36Z","timestamp":1762848516117,"version":"build-2065373602"},"reference-count":14,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Transcatheter aortic valve implantation (TAVI) is a viable treatment of choice in patients with severe aortic stenosis across a wide spectrum of surgical risks (inoperable-high-moderate-low risk). Valve-in-valve (ViV) TAVI has emerged as a valid treatment option in patients with failed aortic bioprosthetic valves, especially in those with intermediate, high or prohibitive risk of surgery.<\/jats:p>\n                  <jats:p>ViV TAVI in patients with prior surgical bioprosthesis presents significant challenges, particularly in cases with stentless valves or radiolucent posts. Therefore, adequate pre-procedural planning is of utmost importance to its success. However, our case had multiple challenges that had to be overcome, including radiolucent posts, residual chronic type A aortic dissection flap in the non-coronary cusp and large body habitus with Killip class IV. Having successfully navigated the above challenges, we report this interesting and complex case of ViV TAVI which was a procedural success associated with significant improvement and recovery.<\/jats:p>","DOI":"10.1136\/bcr-2025-265394","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T08:05:23Z","timestamp":1762848323000},"page":"e265394","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Valve-in-valve transcatheter aortic valve implantation in a patient with residual chronic type A aortic dissection"],"prefix":"10.1136","volume":"18","author":[{"given":"Adeogo Akinwale","family":"Olusan","sequence":"first","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Rajendran","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madiha","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia","family":"Hussain","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amerjeet","family":"Banning","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Rajendra","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elved Bryn","family":"Roberts","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Kovac","sequence":"additional","affiliation":[{"name":"Cardiology, Glenfield Hospital, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2025111100051663000_18.11.e265394.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"2025111100051663000_18.11.e265394.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910555"},{"key":"2025111100051663000_18.11.e265394.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307447"},{"key":"2025111100051663000_18.11.e265394.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.02.057"},{"key":"2025111100051663000_18.11.e265394.5","first-page":"122","article-title":"Valve-in-valve transcatheter aortic valve replacement or re-surgical aortic valve replacement in degenerated bioprostheses: A systematic review and meta-analysis of 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