Management of a patient undergoing multiple aortic valve implantations: TAVI in TAVI in SAVR.

We describe here a case in which a patient underwent multiple aortic valve interventions in a long period of time. Sinus sequestration, coronary occlusion, and prosthesis-patient-mismatch (PPM) may occur during TAVI in failing surgical or transcatheter aortic valves. When life expectancy exceeds bioprosthetic valve durability, the first prosthesis implanted might impact on subsequent interventions. This paper discusses the strategies, role of imaging, concerns, and outcomes in this care pathway.