What does this research mean for the field?

TAV-in-TAV implantation is an effective and safe bailout intervention for managing acute prosthetic failure and severe regurgitation immediately following transcatheter aortic valve implantation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This case examines the use of TAV-in-TAV for treating acute failure of a transcatheter aortic valve in a high surgical risk patient.

May 30, 2026ARQUIVOS BRASILEIROS DE CARDIOLOGIA - IMAGEM CARDIOVASCULAR0 citationsOpen Access

TAV-in-TAV for Acute Failure of a Transcatheter Aortic Valve in a High Surgical Risk Octogenarian Patient

GCGustavo Carvalho MCMaria Fernanda Miranda Carvalho ÊGÊnio Eduardo Guérios

Key Result

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Key Points

This case examines the use of TAV-in-TAV for treating acute failure of a transcatheter aortic valve in a high surgical risk patient.
Patient underwent transfemoral TAVI with a self-expanding prosthesis followed by TAV-in-TAV with a balloon-expandable prosthesis due to acute valve dysfunction.
Quick assessment of hemodynamic status and immediate intervention were implemented.
Immediate hemodynamic recovery was observed post TAV-in-TAV implantation, resolving acute prosthetic regurgitation.
Demonstrated efficacy and safety of TAV-in-TAV as a bailout intervention in high-risk cases.

Structured PICO

Does TAV-in-TAV resolve acute prosthetic failure and hemodynamic instability in a patient undergoing TAVI?

Population

82-year-old patient with severe aortic valve stenosis and high surgical risk (chronic renal dysfunction, restrictive lung disease) experiencing acute prosthetic failure immediately after TAVI

Intervention

TAV-in-TAV using a 21.5 mm balloon-expandable Myval prosthesis

Outcome

Resolution of critical condition and immediate hemodynamic recovery

TAV-in-TAV can serve as an effective and safe bailout intervention for acute prosthetic failure during transcatheter aortic valve implantation.

Abstract

DOI: 10.36660/abcimg.20250111i An 82-year-old patient with severe aortic valve stenosis and high risk for conventional surgery due to chronic renal dysfunction and restrictive lung disease underwent transfemoral transcatheter aortic valve implantation (TAVI) using a self-expanding Navitor ® prosthesis (Abbott). Immediately after implantation, valve dysfunction was observed, characterized by inversion of the right coronary leaflet, resulting in severe acute prosthetic regurgitation and hemodynamic instability. Therefore, a 21.5 mm balloon-expandable Myval ® prosthesis was also implanted (TAV-in-TAV). The critical condition was resolved with immediate hemodynamic recovery. This case demonstrates the efficacy and safety of TAV-in-TAV as a bailout intervention in acute prosthetic failure. Keywords: Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Heart Valve Prosthesis ; Prostheses and Implants 51

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