Abstract
In our case, AR was actually due to the sequelae of endocarditis and not to structural valve degeneration. Technical issues for TAVIin patients with stentlessbioprostheses are different from thoseinpatientswithnativeaorticstenosis or a stented bioprosthesis. Positioning may be more difficult because of the absence of calcification, and the role of concomitant TEE should be emphasized. The absence of calcification or stents may also theoretically increase the risk of prosthesis migration because of potentially less stable anchorage on the aortic annulus. However, this report illustrates the feasibility of TAVI in patients with severe dysfunction of a stentless bioprosthesis. Valve-in-valve implantation may represent a promising opportunity for the future, 5 inasmuch as limited durability is the major concern of stented or stentless bioprostheses. Further studies including a large number of patients and longer follow-up arerequiredtodefinethe exactroleofTAVIin elderly patients with a degenerated bioprosthesis that requires reintervention.
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