Predicting Treatment of Bioprosthetic Aortic Valve Failure in the United States: A Proposed Model

•Transcatheter aortic valve replacement (TAVR) is the dominant treatment for aortic stenosis; the need to treat TAVR failure is increasing.•TAVR valve-in-valve (ViV) is predicted to reach ∼42,000 procedures by 2035.•TAVR ViV will represent ∼15% of all TAVR performed by 2035.•TAVR-in-TAVR will match TAVR-in-surgical aortic valve replacement by 2028 and dominate thereafter.•To ensure the viability of TAVR ViV, the use of leaflet modification is needed.