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It was reported that on (b)(6) 2026, a 25 mm navitor vision valve was selected for a valve-in-valve procedure.The navitor valve was implanted within a 25 mm non-abbott surgical aortic valve that had been implanted in 2015.No pre-dilation was performed.The patient's aortic valve angle was reported as 43 degrees.During the procedure, the implant depth at approximately 80% deployment was reported as 4 mm at the non-coronary cusp (ncc) and 4 mm at the left coronary cusp (lcc).The navitor valve was successfully released; however, upon release, the non-marker side of the navitor valve moved upward.Immediately prior to migration, the implant depth of the navitor valve was reported as 2 mm below the 25 mm non-abbott valve frame.It was clarified that the valve moved superiorly toward the aortic arch.The final implant depth after migration was reported as 0.0 mm at the non-coronary cusp (ncc) and 2.0 mm at the left coronary cusp (lcc).Moderate to severe paravalvular leak (pvl) was observed.The implanter checked for non-uniform expansion (nue), and no nue was observed.No eccentric calcification or anatomical/tissue-calcium interference affecting valve expansion was reported.Post-dilation was performed using a 24 mm non-abbott balloon; however, moderate pvl persisted.As a result, the physician decided to implant a 23 mm non-abbott valve with an additional 2 cc added to the deployment balloon.The 23 mm non-abbott valve was implanted inside the 25 mm navitor valve, which was implanted inside the 25 mm non-abbott surgical aortic valve.Following implantation of the 23 mm non-abbott valve, the pvl was reduced to mild.The implanter was unsure of the cause of the migration.The echocardiogram closest to discharge demonstrated trace pvl.The patient remained hemodynamically stable throughout the procedure.No clinically significant delay was reported.The patient's status was reported as discharged.
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