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Updated: Jun 26, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
High-Risk Valve-in-Valve TAVR With Chronic Type B Aortic Dissection
Koushik Kondapi1, Elizabeth Evans2, Fareed Moses Collado2
1Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
Background:
Transcatheter aortic valve replacement (TAVR) is a challenge in patients with chronic aortic dissection given risk of intraoperative dissection extension. There are limited prior case reports.
Case Summary:
A 45-year-old man with a history of repaired type A dissection and aortic valve replacement with residual type B dissection presented in cardiogenic shock due to severe prosthetic valve stenosis. Because of his surgical risk and rapid decompensation, a valve-in-valve TAVR was successfully performed, followed by resolution of cardiogenic shock.
Discussion:
We demonstrate a successful valve-in-valve TAVR in a patient with known type B dissection in the setting of hemodynamic deterioration.
Take-Home Messages:
TAVR is uniquely challenging in patients with type B aortic dissection but is feasible in the acute setting. Femoral access requires special attention to ensure entry into the true lumen.
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