fig3

Figure 3. TAVR-in-TAVR after ViV TAVR. A degenerated Carpentier-Edwards Perimount 27 mm bioprosthesis (Edwards Lifesciences, Irvine, California, USA) treated with a first TAVR CoreValve Evolut R 29 mm (Medtronic, Minneapolis, Minnesota, USA) and a subsequent Sapien3 Ultra 26 mm (Edwards Lifesciences, Irvine, California, USA), due to damage to CoreValve leaflets after post-dilation by incomplete expansion with severe aortic regurgitation.