Transcatheter aortic valve implantation (TAVI) has been increasingly performed in failing aortic bioprosthesis, but these “valve-in-valve” procedures are technically more challenging (1,2). The Direct Flow transcatheter aortic valve was implanted worldwide (3,4) before its eventual withdrawal from the market. We describe a case of repeat TAVI in a failing Direct Flow valve and discuss the technical considerations involved (no data in the “Valve-in-Valve” app).
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