Surgical Explantation of Stenotic Self-Expandable Transcatheter Aortic Valve With Aortic Root Enlargement.

A 73-year-old woman with history of severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) with a size 23 self-expandable valve 5 years ago presented with symptomatic severe bioprosthetic aortic stenosis. Given the small aortic annulus and high risk for coronary occlusion in a valve-in-valve procedure, she underwent TAVR explantation, surgical aortic valve replacement with aortic root enlargement to put in a size 23 surgical bioprosthetic aortic valve, and ascending aorta replacement due to the injury of intima in the ascending aorta. Her recovery was complicated by complete heart block. She required permanent pacemaker placement on postoperative day 1 and was discharged home on postoperative day 7.