Valve-in-Valve TAVI in a patient at high risk of coronary obstruction

In this case chapter, we discuss a case of a 97-year-old female, with past medical history of surgical aortic valve replacement in 2010 ( with a 21mm Trifecta valve), hypertension, chronic kidney disease, who presents with recurrent heart failure hospitalizations. She was found to have severe stenosis of her prosthetic aortic valve. We review her diagnostic studies, work up, and management. We discuss our step-by-step procedural approach.