Valve migration into the left ventricular outflow tract managed by coaxial double-valve alignment

The efficacy and overall safety of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis at high risk for conventional surgery is validated. Nevertheless, infrequent, but severe, intraprocedural complications, often necessitating intraoperative bailout maneuvers, are reported. Among these, valve migration into the left ventricle is particularly dismal and requires conversion to an emergent surgical procedure with a reported disproportionally high mortality rate. We report herein a case in which valve migration into the left ventricular outflow tract (LVOT) was successfully managed by repositioning a second prosthesis, thus avoiding emergent surgery.