New CoreValve Evolut 23 mm technology for treatment of degenerated bioprosthesis.

The treatment of degenerated surgical bio-prosthetic heart valves (BHV) has been reported as a novel indication for TAVI. The intervention may be complicated by high residual transvalvular gradients and coronary ostia obstruction, especially in small size BHV. We report two cases of BHVs treated with the new CoreValve Evolut 23 mm highlighting the importance of fluoroscopic guidance, based on BHV markers, in achieving a correct TAVI implantation. The small dimensions of the new CoreValve Evolut 23 allowed us to obtain low residual gradients even in this particular subset of degenerated BHV.