Transcatheter aortic valve implantation for severe aortic regurgitation in a stentless bioprosthetic valve with the core valve revalving system-technical tips and role of the Accutrak system.

Transcatheter aortic valve implantation may offer a less invasive alternate to surgical reoperation in patients with failed aortic bioprosthetic valves. Prior reports have focussed on successful transcatheter treatment of stented bioprosthesis. Newer stentless valves offer unique technical challenges. In the absence of radiopaque markers, the deployment is carried out under angiographic control. Device stability is also an important issue in cases of severe regurgitation. We report on the first case of percutaneous replacement of a severely regurgitant degenerated stentless bioprosthesis treated with the new iteration of the core valve system incorporating the Accutrak stability layer. Salient technical expedients have been mentioned and discussed in detail.