Single Institution Experience With Transcatheter Valve-in-Valve Implantation Emphasizing Strategies for Coronary Protection

Jeopardizing coronary blood flow is likely in stenotic and calcified bioprostheses, particularly in tubelike aortic sinuses. Planning, imaging, and the use of valves allowing commissural alignment as well as leaflet capturing seem to reduce the risk. Further studies are necessary to support this hypothesis.