Valve in Valve: Three-Dimensional Transoesophageal Echocardiogram and Multi-Slice CT Images of Bio-Prosthetic Aortic Valve Replaced by Medtronic CoreValve

previously undergone bio-prosthetic aortic valve implantation in 2004 for aortic stenosis. When he re-presented with heart failure in 2012 due to re-stenosis of the aortic valve bio-prosthesis, he was deemed not suitable for re-do surgery because of high-risk involved. Thus, he had TAVI using Medtronic CoreValve. Three-dimensional transoesophageal echocardiogram (3D TEE) and multi-slice contrast enhanced computed tomography (CT) scan were performed to look for the source of infection. 3D TEE clearly showed the grove of CoreValve in Valve-in-valve trans-cutaneous aortic valve implantation (TAVI) is now feasible and in a recent multi-centre study showed performed with high technical success rates, acceptable post-procedural valvular function, and excellent functional improvement. Multi-modality cardiac imaging in such patient’s is slowly becoming routine and it is becoming pivotal for physicians to recognize structural and anatomical changes present in such patients. A 70-year-old gentleman was admitted to our unit with pyrexia and suspected infective endocarditis. He had pISSN 1975-4612/ eISSN 2005-9655 Copyright © 2014 Korean Society of Echocardiography www.kse-jcu.org http://dx.doi.org/10.4250/jcu.2014.22.4.230