biostudies-literatureUnknown30(22)Mitsui K<h4>Background</h4>Index transcatheter aortic valve (TAV) expansion during TAV-in-TAV is crucial as it changes the valve-to-aorta distances and may increase the intraprocedural risk.<h4>Case summary</h4>A TAV-in-TAV procedure was planned for a 90-year-old woman with prior TAV replacement (23-mm SAPIEN XT) who presented with prosthetic valve stenosis. Second TAV sizing was assessed by averaging the stent areas of the index TAV and by drawing a virtual circle on preprocedural computed tomography (CT). CT imaging also revealed significant calcification of the index TAV leaflets. The team opted for a one-size-smaller 20-mm SAPIEN3 valve. During the procedure, the index TAV expanded by creating a gap between the 2 valve stents. Postprocedural CT confirmed index TAV expansion and the calcified lJACC. Case reports104499https://www.ebi.ac.uk/biostudies/studies/S-EPMC12426519biostudies-literatureIndex Transcatheter Aortic Valve Expansion After TAV-in-TAV Using a One-Size-Smaller SAPIEN Valve.PMC12426519Kawamoto NOkada AMitsui KTakagi KfalseIndex Transcatheter Aortic Valve Expansion After TAV-in-TAV Using a One-Size-Smaller SAPIEN Valve.<h4>Background</h4>Index transcatheter aortic valve (TAV) expansion during TAV-in-TAV is crucial as it changes the valve-to-aorta distances and may increase the intraprocedural risk.<h4>Case summary</h4>A TAV-in-TAV procedure was planned for a 90-year-old woman with prior TAV replacement (23-mm SAPIEN XT) who presented with prosthetic valve stenosis. Second TAV sizing was assessed by averaging the stent areas of the index TAV and by drawing a virtual circle on preprocedural computed tomography (CT). CT imaging also revealed significant calcification of the index TAV leaflets. The team opted for a one-size-smaller 20-mm SAPIEN3 valve. During the procedure, the index TAV expanded by creating a gap between the 2 valve stents. Postprocedural CT confirmed index TAV expansion and the calcified l2025-01-01T00:00:00Z2025 Aug2026-04-08T19:55:08.268Z2026-04-08T14:36:22.299ZS-EPMC124265194078079910.1016/j.jaccas.2025.104499