The history of aortic valve surgery began with the Hufnagel procedure. In 1953, Hufnagel reported the first successful treatment of aortic insufficiency by the implantation of a ball-valve prosthesis into the descending aorta. We present a 33-year-old male patient with a complicated surgical history needing a sixth-time redo aortic valve replacement for severe prosthetic paravalvular leak in the presence of fresh intracranial hemorrhage. His deteriorating clinical picture was successfully temporized by a transcatheter valve placement in the descending aorta (modified Hufnagel procedure). This report illustrates a potential role of a modified Hufnagel procedure as a bridge to definitive surgery.
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