Severe Valvular Regurgitation: An Unexpected Complication During Transapical Aortic Valve Implantation Treated Successfully with the 'Valve-in-Valve' Procedure

Severe symptomatic aortic stenosis (AS) in a multimorbid 77 year old female was treated with transapical aortic valve implantation with a 23 mm Edwards Sapien valve. Severe valvular regurgitation following implantation, probably due to structural valve failure, was treated successfully with a second valve-in- valve implantation. During a follow-up time of 2,5 years no further problems occurred.