CONCLUSIONS
In conclusion, in our series, a planned valve-in-valve TAVR in patients with aortic insufficiency, although not commonly used, is a reasonable option for patients who are unable to undergo an operative surgical aortic valve replacement. As the use of LVAD increases, symptomatic aortic insufficiency in this group of high-risk patients will become an increasingly common challenge. Further studies are needed to evaluate the efficacy of TAVR and VIV TAVR for the treatment of native or LVAD associated aortic insufficiency.