Since its implantation in 2002, transcatheter aortic valve implantation (TAVI) has become the preferred intervention for patients with severe aortic stenosis and significant co-morbidities. In 2007, it was adopted as a rescue procedure for failed bioprosthetic valves, now known as the valve-in-valve (VIV) procedure. Unlike other modes of treatment with a multitude of phase 4 post-marketing surveillance (PMS) data, use of these valves have increased rapidly even without long term durability data on this procedure and the near lack of information on the pathology of failed transcatheter aortic valve replacement (TAVR) bioprosthesis and especially after the VIV procedure. We present a case of a late explanted VIV bioprosthesis (ten (10) years post-initial aortic valve replacement and five (5) years post-VIV procedure) in a 65-year-old male with multiple morphologic findings. Further availability of standardized morphologic data from explanted bioprosthetic valves is essential to aid in understanding the pathophysiology of tissue degeneration of the TAVI valve, and ultimately to improve patient outcomes by identifying possible early interventional strategies.

自 2002 年植入以来，经导管主动脉瓣植入术 (TAVI) 已成为严重主动脉瓣狭窄和严重合并症患者的首选干预措施。2007 年，它被用作失败的生物人工瓣膜的抢救程序，现在称为瓣中瓣 (VIV) 程序。与具有大量 4 期上市后监测 (PMS) 数据的其他治疗模式不同，即使没有关于该程序的长期耐久性数据以及几乎缺乏经导管主动脉瓣失败的病理信息，这些瓣膜的使用也迅速增加置换 (TAVR) 生物假体，尤其是在 VIV 手术之后。我们在一名 65 岁的男性中介绍了一例晚期移植的 VIV 生物假体（初始主动脉瓣置换术后十 (10) 年和 VIV 手术后五 (5) 年），具有多种形态学发现。进一步提供来自移植生物瓣的标准化形态学数据对于帮助理解 TAVI 瓣膜组织变性的病理生理学至关重要，并最终通过确定可能的早期介入策略来改善患者的预后。