60 yearold male presents with worsening exertional dyspnea (NYHA Class III) and multiple admissions for CHF exacerbation in past 3 months. Past medical history is significant for symptomatic severe aortic insufficiency s/p bioprosthetic AVR (2017) with 23mm Magna 3000 valve, ESRD on HD, HTN and HLD. Recent echocardiogram revealed bioprosthetic valve degeneration with severe aortic stenosis (PG/MG/AVA of 75/51/0.67) and depressed LVEF of 30%. Coronary angiogram showed moderate 2V CAD being medically managed. Lower extremities on CT angiogram revealed calcified arteries with vessel size < 6mm. The Internal diameter of surgical AV measured 21.5×22.3mm (mean 21.9mm), perimeter 68.3mm and the area 370.6 mm2. The STS mortality risk for surgical AVR was calculated at 5.83%. The patient underwent Heart Team evaluation and was found to be at high risk for redo SAVR due to comorbidities and frailty. Now planned for ValveinValve TAVR with 26mm Evolut Pro+ CoreValve and bioprosthetic valve fracture using 23mm True Balloon via right percutaneous femoral approach.