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When Valve-In-Valve Implantation Is Not Sufficient: Bioprosthetic Russian Dolls Elaine E. Tseng, MD † †Department of Surgery, University of California at San Francisco Medical Center (UCSF) and San Francisco Veterans Affairs Medical Center (SFVAMC), San Francisco, CA. Address for correspondence: Elaine E. Tseng, MD UCSF Medical Center, Division of Cardiothoracic Surgery 500 Parnassus Avenue, Suite W405, Box 0118 San Francisco, California 94143-0118 Telephone: 415-221-4810 x23452 FAX: 415-750-2181 E-mail: elaine.tseng@ucsf.edu Word Count: 497

When valve-in-valve implantation is not sufficient: Bioprosthetic Russian dolls