Cusp Overlap Technique During Valve-in-Valve TAVI Using the Novel Navitor Transcatheter Heart Valve

A 67-year-old male was referred for valve-in-valve (VIV) transcatheter aortic valve implantation (TAVI) in view of symptomatic, severe structural valve deterioration of a 23 mm Perimount 2800 (Edwards Lifesciences, USA) implanted 12 years earlier due to a severely stenotic bicuspid aortic valve. Latest transthoracic echocardiography showed a mean trans-prosthetic gradient of 80 mmHg, but no regurgitation. Pre-procedural computed tomography (CT) revealed adequate virtual valve-to-coronary distances (> 4 mm) (Figure 1A). The patient was scheduled for VIV-TAVI with a 25 mm Navitor™ (Abbott, USA) under local anesthesia. Compared to the Portico™ system (Abbott, USA), this latest-generation Navitor™ transcatheter heart valve (THV; Figure 1B) has an active outer NaviSeal™ cuff to prevent paravalvular leakage (PVL), optimized radial force, and a curved aortic outflow part to mitigate risk of aortic injury.