Transfemoral access for valve in valve implantation of an Edwards Sapien XT valve in a stenotic tricuspid bioprosthesis under fluoroscopic guidance

A 53-year-old man presented with a high grade stenotic tricuspid bioprosthesis and an inoperable state because of progressive lung disease. Valve replacement was performed transfemorally under local anaesthesia without rapid pacing. Valve positioning was facilitated by the radiopaque frame of the degenerated bioprosthesis. Echocardiography revealed a decrease of peak tricuspid valve gradient from 18to 8 mm Hg. Valve-in-valve implantation of an Edwards Sapien XT valve in a failing tricuspid bioprosthesis is feasible via transfemoral access without general anaesthesia or rapid pacing.