INTRODUCTION
Historically, transcatheter aortic valve replacement (TAVR) has been used to treat patients with aortic stenosis, deemed high risk for surgical aortic valve replacement1. Recently, indications for TAVR have been expanded to intermediate and low-risk patients, and the use of TAVR in patients with aortic insufficiency is now being explored2. In this report, we will present and discuss the methodology employed in two cases of severe, symptomatic aortic insufficiency that underwent TAVR as treatment of pathology after being deemed prohibitive risk by an experienced Heart Valve team. The use of a Balloon-expandable Edwards SAPIEN valve to stabilize the initial deployment of a self-expandable Medtronic Evolut value is described.