Treatment of a degenerated sutureless Sorin Perceval® valve using an Edwards SAPIEN 3.

Valve-in-valve implantation is an alternative to reoperation for patients with degenerated bioprostheses. This case report presents a 75-year-old woman presenting with worsening dyspnoea according New York Heart Association (NYHA) Class III after she had received a Sorin Perceval® S sutureless valve due to severe aortic valve stenosis 5 years ago. Echocardiography revealed a degenerated Perceval valve with severe valvular aortic regurgitation and stenosis. After exclusion of acute infective endocarditis, an Edwards SAPIEN 3 was implanted leading to an immediate haemodynamic improvement. A cerebral protection device caught a big embolized piece of material in the left carotid artery filter. The case demonstrates that not only suture-based stented and stentless bioprostheses can be treated by a valve-in-valve strategy, but it is also feasible to treat a failed sutureless Sorin Perceval using a balloon-expandable SAPIEN 3.