Kornowski R, Chevalier B, Verhoye JP, et al. - A surgical valve replacement is often performed to treat patients with symptomatic aortic stenosis. Degeneration of surgical bioprosthetic valves over time may necessitate a redo surgery. In this study, the 2-year clinical outcomes of the Valve-in-Valve study were reported, in which evaluation was performed of transcatheter aortic valve implantation using the CoreValve and Evolut R devices in patients with degenerated surgical aortic bioprostheses at high risk for surgery. A total of 202 eligible patients with failing surgical aortic bioprostheses due to stenosis, regurgitation, or a combination of both were enrolled in the prospective Valve-in-Valve study. Use of the Evolut R bioprosthesis was made in 90.5% of valve-in-valve transcatheter aortic valve implantation cases. Two-year all-cause and cardiovascular mortality rates of 16.5% and 11.1%, respectively, were reported. Overall findings suggest that valve-in-valve treatment employing a supra-annular self-expanding bioprosthesis results in significant functional improvements with acceptable rates of complications in patients with failing surgical aortic bioprostheses; this is particularly noted if a postprocedural mean gradient of < 20 mmHg can be achieved.