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Acute coronary artery occlusions complicating a valve-in-valve-in-valve procedure
  1. Gonzalo Barge-Caballero,
  2. Jorge Salgado-Fernández,
  3. Nicolás Vázquez-González
  1. Department of Cardiology, A Coruña University Hospital, A Coruña, Spain
  1. Correspondence to Dr Gonzalo Barge-Caballero, Department of Cardiology, A Coruña University Hospital, Avenida Julio Rodríguez Soto, N° 63, 8° B., O Carballiño (Ourense), CP: 32500, Spain; Gonzalo.Barge.Caballero{at}

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An 83-year-old female with prior 23-mm Mitroflow biological prosthetic aortic valve replacement (Sorin Group Inc, Mitroflow Division, Vancouver, Canada), symptomatic severe periprosthetic regurgitation and preserved left ventricular ejection fraction was referred for transcatheter aortic valve implantation (TAVI). Preprocedural catheterisation showed normal coronary arteries and severe aortic regurgitation. Although TAVI is licensed for treating native valve aortic stenosis it can be used off label for treating bio-prosthetic valve failure due to aortic regurgitation.

A 23-mm Edwards SAPIEN transcatheter aortic prosthetic valve (Edwards Lifesciences, Irvine, California, USA) via right femoral artery was deployed. Due to persistence of severe …

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