1. 1. What is going on here? Why are there two valves? Where are the two valves? 89 Year Old Female 1 Year Post TAVR
2. 2. 88 yo female with severe, symptomatic AS, STS 7.9 CTA annulus 21.4 x 25.8, perimeter 75.3 mm RFA cutdown, BAV 20x5 balloon, 29 mm Corevalve Valve deployed to 2/3 position with severe PVL What to do next? 89 Year Old Female 1 Year Post TAVR
3. 3. Low implant with PVL around valve skirt Attempted pull back with pop-out of valve Valve pulled into descending aorta but unable to reach sheath, so deployed in thoracic aorta 89 Year Old Female 1 Year Post TAVR
4. 4. 2nd valve deployed with mild PVL One year later patient with trace AR, and no obstruction from 1st valve Take Home Points: Severe PVL needs to be treated Valve in Valve acceptable Can pull back Corevalve but need to be prepared for pop-out with 2nd valve 89 Year Old Female 1 Year Post TAVR