THV-in-THV for Failed Self-Expandable Prothesis in 53 y.o. patient

A 53-year-old woman with severe comorbidities, including hypertension, diabetes, and COPD, underwent a THV-in-THV procedure after the failure of a prior Evolut R 29 valve (2017) due to regurgitation and stenosis. The procedure used a Sapien 26 valve with femoral access and coronary protection. Post-procedure outcomes showed improved aortic gradients (31/19 mmHg) with trivial regurgitation. The patient was discharged in NYHA class I, on NOAC therapy, with a follow-up CT planned for September 2024.