The patient, male, 80 years old, underwent aortic valve replacement in 2014 due to the surgical operation of severe aortic stenosis due to rheumatic heart disease. In this year, after walking 500 meters, he felt chest tightness and suffocation, and rest could improve. He had a history of hypertension for 40 years. Grade III-IV/6 systolic murmur can be heard in the auscultation area of aortic valve.

Mean Gradient  77mmHg Peak Velocity 5.68m/s  EF 60%LVEDD  41mmCT results：Annulus  22.4mm，LVOT  23.6mm，L33.2 * R30.3 * N32.1，SOV P  112.9mm，STJ  28.9mm，AA 36.7mm，LV  26.3mm，LV  30.9*56.6mm，Low height of coronary opening，No redundant leaflets seen，Sinus space canEstimated low risk of occlusion

Coronary angiography with normal coronary artery

In the case of biological valve failure, the original biological valve is relatively small, and the estimated valve shape has a significant impact. The anchoring is acceptable, and there is a certain risk of decline during the release process. It is expected that the TaurusElite AV23 valve will be implanted through the right femoral main approach without pre dilation, with initial positioning at 0 position. After the valve is released to the working position, the valve position and shape will be fully evaluated in multiple positions. Based on the ultrasound results, it will be confirmed that there is no error before release. In the first four times, the valve has slipped a lot, and a replacement position will be considered, After multi angle adjustment, it was found that the central position of the right sinus was still better for rapid pacing release to the working position, with a multi angle contrast ratio of about 8mm. Ultrasound showed no significant limitation of the mitral valve, and the hemodynamic results were satisfactory. Considering the possibility of the valve frame moving down again from the coaxial axis, it was decided to release to the extreme recovery position to observe the valve frame moving down
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