{
  "abstract": "Given the diverse technical challenges associated with transcatheter valve-in-transcatheter valve procedures, the treatment strategy for each clinical case must be tailored to the individual patient.We present the case of a man in his late 70s with a complex clinical history, including two prior transcatheter aortic valve implantation (TAVI) procedures and infective endocarditis, who later developed severe degeneration of the aortic prosthesis requiring a third transcatheter intervention.Initially treated with a Lotus valve in 2014, the patient underwent a TAV-in-TAV with an Evolut prosthesis in 2022, followed by endocarditis-related degeneration and severe restenosis. In 2024, a third prosthetic valve (Acurate neo2) was implanted using the TAV-in-TAV-in-TAV technique.With expanding indications for TAVI and increasing longevity among treated patients, complex multi-prosthesis interventions may become more frequent, highlighting the need for improved procedural planning, imaging strategies and long-term surveillance. At 1-year follow-up, the patient remains asymptomatic with preserved valve function.This case illustrates the feasibility of a third TAVI after treated prosthetic valve endocarditis, supported by CT-guided procedural planning and 1-year follow-up, which remains scarcely reported in the literature.",
  "authors": [
    {
      "affiliations": [
        "Endovascular Diagnostics and Treatment, FSBI Academician E I Chazov National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Moscow, Russian Federation"
      ],
      "name": "Evgeny Vladimirovich Merkulov"
    },
    {
      "affiliations": [
        "Endovascular Diagnostics and Treatment, FSBI Academician E I Chazov National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Moscow, Russian Federation"
      ],
      "name": "Goar Kimovna Arutyunyan"
    },
    {
      "affiliations": [
        "Endovascular Diagnostics and Treatment, FSBI Academician E I Chazov National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Moscow, Russian Federation"
      ],
      "name": "Andrey Sergeevich Tereshchenko"
    },
    {
      "affiliations": [
        "Emergency Cardiology Department, FSBI Academician E I Chazov National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Moscow, Russian Federation"
      ],
      "name": "Dmitriy V Pevzner"
    },
    {
      "affiliations": [
        "Emergency Cardiology Department, FSBI Academician E I Chazov National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Moscow, Russian Federation"
      ],
      "name": "Iiliya Tarasovich Zyuryaev"
    },
    {
      "affiliations": [
        "Emergency Cardiology Department, FSBI Academician E I Chazov National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Moscow, Russian Federation"
      ],
      "name": "Mariya Alekseevna Terenicheva"
    },
    {
      "affiliations": [
        "LLC «Cardiomedics», Moscow, Russian Federation"
      ],
      "name": "Olga Nickolaevna Ganeeva"
    },
    {
      "affiliations": [
        "LLC «Cardiomedics», Moscow, Russian Federation"
      ],
      "name": "Alexey Vladimirovich Knigin"
    }
  ],
  "title": "TAV-in-TAV-in-TAV after treated endocarditis: procedural strategy, imaging planning and 1-year outcome",
  "uid": "3f903622-7fd8-5364-a674-3b0c0b86baf0"
}