A 73-year-old previously healthy man, presented with cardiogenic shock and ventricular tachycardia (VT) storm due to critical aortic stenosis (mean invasive gradient of 84 mm Hg across the aortic valve) with moderate aortic incompetence (AI) causing severe left ventricular dysfunction (ejection fraction 10%), underwent transcatheter aortic valve replacement (TAVR) within 3 hours of review by TAVR team. Urgent CT demonstrated a type 1 bicuspid aortic valve with an extremely large aortic annulus exceeding the maximum dimensions for all TAVR bioprostheses (area 988 mm2, perimeter 112.3 mm, minimum and maximum diameter of 33 mm and 38 mm respectively, LVOT diameter 29 mm) and extreme calcification of the valve leaflets. An urgent TAVR proceeded with a 29 mm self-expanding bioprosthesis (Abbott Portico Self-Expanding Valve). The dense, cauliflower-like leaflet calcification was used to anchor the prosthesis in a high position creating a neo-annulus from the valve tissue, modifying a technique that has been described for the management of type 0 bicuspid valves with a fibrotic ovoid orifice. Following deployment, initial significant prosthesis constraint with moderate paravalvular leak (PVL) with two main jets were noted on transesophageal echo. Multiple post-dilatations using an overfilled 28 mm Nucleus-X balloon were performed. The AI index at the end of the procedure was 0.41 indicating mild PVL. LVEF improved to 30%, 1-week post-TAVR. This case highlights that emergency TAVR can be life-saving in a challenging anatomy, illustrating a strategy of creating a high neo-annulus using extreme leaflet calcification where the true native annulus size exceeds current device capabilities.