Degenerated Suturless Perceval with (Paravalvular Leak and AS) Treated by Valve in Valve using S3 Edward Valve

A 70-year-old female patient, known to be diabetic and hypertensive, was diagnosed with coronary artery disease and severe aortic stenosis aortic valve area 0.5 cm, peak gradient of 110 mmHg, mean gradient 55 mmHg). This patient underwent coronary artery bypass graft with two grafts and artery bypass grafting in 2012. She received a sutureless Perceval aortic valve with good postoperative results except for a small jet of paravalvular leak. She did well for 5 years until she began experiencing dyspnea on exertion. The patient was found to have moderate to severe aortic regurgitation and moderate aortic stenosis which progressed over the years with multiple admissions for heart failure and pulmonary edema. The patient was considered high risk for operative treatment. Therefore, she was treated by percutaneous valve-in-valve technique using S3 Edward valve with excellent results.