Javier M. Olarte, MD, Fernando D. Lopez, MD, Jose M

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Transcatheter Valve-in-Valve Replacement Through Apicoaortic Conduit for Aortic Bypass Valve Failure  Javier M. Olarte, MD, Fernando D. Lopez, MD, Jose M. Barquero, MD, Roman Calvo, MD, PhD, Antonio Fernández, MD, PhD, Francisco González, MD, PhD, Rafael Hidalgo, MD, Omar A. Araji, MD, PhD  The Annals of Thoracic Surgery  Volume 105, Issue 1, Pages e21-e22 (January 2018) DOI: 10.1016/j.athoracsur.2017.08.026 Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A, B) Computed tomography shows a heavily calcified root and aortic prosthesis, giving a very high risk of rupture and coronary ostia obstruction for the regular approach or transcatheter aortic valve implantation. (C) A three-dimensional computed tomography image shows localization, distance, and characteristics of the conduit valve. The arrows show the desired insertion site and the localization of the failure valve and point to the site for release of the Sapien 3 (Edwards Lifesciences, Irvine, CA) valve. The Annals of Thoracic Surgery 2018 105, e21-e22DOI: (10.1016/j.athoracsur.2017.08.026) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Direct fluoroscopy image at the moment of 23-mm Sapien 3 (Edwards Lifesciences, Irvine, CA) valve implant through the conduit. (B) Valve-in-valve deployment and release. The Annals of Thoracic Surgery 2018 105, e21-e22DOI: (10.1016/j.athoracsur.2017.08.026) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions