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The "valve-in-valve" concept may be applied in patients with previously implanted biological aortic valve prostheses. There are few reports of individual cases and as yet no clinical proof of safety and feasibility in a larger group of patients. We report the single-center outcome of transapical implantation of aortic valves into degenerated biological aortic valve prostheses ("valve-in-valve") in very high-risk patients.

Transapical aortic valve implantation after previous aortic valve replacement: Clinical proof of the “valve-in-valve” concept