Valve-in-Root TAVI vs Redo Surgery in a Young Adult With Failed Bioprosthesis.

Authors

Rushmi Purmessur, Luigia D'Errico, Charis Costopoulos, Jason Ali

Published in

JACC. Case reports. Pages 110733. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

Whether valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) or redo surgical aortic valve replacement (SAVR) is preferred for structural valve degeneration of a Freestyle stentless aortic root in a young adult, and whether a Ross procedure at index surgery would have better served lifetime management.
A 30-year-old man with a failed stentless aortic root (implanted at age 20 for bicuspid aortic valve regurgitation) presented with severe bioprosthetic regurgitation and ventricular dilatation. Transfemoral ViV TAVI with a 29-mm Edwards SAPIEN 3 Ultra Resilia was performed successfully.
ViV TAVI avoids redo sternotomy, preserves future options, and aligns with patient preference to avoid anticoagulation.
Redo SAVR with a mechanical valve-and a Ross procedure at the index operation-may offer superior lifetime sequencing, avoiding constraints of successive transcatheter implants.
Lifetime planning must begin at the index operation; both ViV TAVI and redo SAVR require heart team deliberation with explicit consideration of all future interventions.

PMID:
42886117
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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