The first TAVI was performed in 2002, in France, by Professor Alain Cribier, since then the technology has rapidly expanded. Currently 2021 European Society for Cardiology guidelines give a class 1 recommendation, for the use of TAVI, in patients >75years old or who are high-risk for surgery (based on risk scores: STS-PROM or EUROSCORE). Valve-in-valve TAVI represents a niche percutaneous approach for patients with severe symptomatic aortic stenosis/regurgitation, secondary to degeneration of a previous surgically implanted bioprosthetic valve. Heart team approach to these cases involving, interventional cardiologists, non-interventional cardiologists and cardiothoracic surgeons is international best practise. At these meetings; clinical, anatomical and procedural factors are evaluated to choose the correct valve and approach for each patient. We describe a case below to highlight this concept.