Transcatheter aortic valve implantation is a new and innovative method for the treatment of severe aor- tic stenosis in patients with high perioperative risk for conventional cardiac surgery. This procedure is also a possible alternative for patients with failed surgical bi- oprosthesis and may obviate the need for reoperation. We report a case of successful transcatheter valve-in- valve (VIV) implantation procedure in 77-years-old man with previous aortic valve replacement with bi- oprosthesis 32 months ago. The echocardiographic fol- low-up revealed a severe valve restenosis. Reoperation, the standard of care for these patients is, in most of the cases, a high-risk procedure, because of their age and comorbidities. So, transcatheter VIV implanta- tion was considered to be more safe and efficient. The procedure was successfully performed with transfem- oral approach, using CoreValve Evolut. The echocar- diographic follow up showed a significant reduction of the transaortic peak systolic gradient from 86 mmHg to 38 mmHg.
