Transcatheter Valve-in-Valve Replacement Through Apicoaortic Conduit for Aortic Bypass Valve Failure

We report a case of a 69-year-old woman who required an apicoaortic bypass conduit after stenosis of a biological aortic prosthesis valve previously implanted 4 years earlier. The patient was admitted to the emergency department 8 years later with a diagnosis of congestive heart failure. Echocardiography and nuclear magnetic resonance revealed severe regurgitation of the conduit valve. Because the patient had a very high Society of Thoracic Surgeons risk score associated to an acute angle between the aorta artery and the apicoaortic conduit, we decided to perform an antegrade and direct transcatheter valve-in-valve implantation on the apicoaortic valve, with a good result.