That’s not a hard rule, we treated a patient who was an IVDU who had 3 aortic valves in 3 years (IV drug users seed bacteria into their system which then form vegetations on heart valves, and there is an increased predisposition for the vegetations to form on foreign material such as replacement valves).

But depending on the damage to the aortic root, that is going to be the primary determinant on if they are going to be able to undergo repeated procedures. I have heard of TAVIs being placed inside precious tissue replacements so that’s potentially the next route for a lot of people, which would mean basically x3, the third replacement being more streamlined than the previous two

That is very informative, thank you.