Valve-in-valve transcatheter aortic valve implantation with Acurate neo for a degenerated bio-Bentall

Abstract A 79-year-old man with heart failure was referred to our attention for a degenerated bio-Bentall Mitroflow 27. The Heart Team decided for a valve-in-valve (ViV) transcatheter aortic valve implantation with an Acurate neo M associated to coronary protection due to high risk of coronary obstruction (CO). Besides the supra-anular design, this case shows additional potential advantages of the Acurate neo in ViV procedures: the upper crown, which is meant to favor supra-anular anchoring, also let to cap the bioprosthesis leaflets and minimize the risk of CO; there is not any interference between the valve cage and the stents protruding into the aorta, avoiding potential stent crushing and assuming an easier future coronary engagement.