A 26-mm Edwards-Sapien percutaneous bioprosthetic valve (Edwards Lifesciences, Inc., Irvine, California) was implanted with the transapical approach, under fluoroscopic and TEE guidance. The PAVR was implanted, to occlude the paravalvular leak, in the left ventricular outflow tract, inferior to the original valve replacement in a valve-in-valve procedure. However, TEE showed increased aortic regurgitation severity due to nondeployment of a single prosthetic aortic cusp ((Figure 1)C, Online Videos 2 and 3). A second 26-mm Edwards-Sapien percutaneous bioprosthetic valve was implanted in-between the 2 previous valves ((Figure 1)D, Online Video 4). Final TEE showed a good result with minimal residual paravalvular leak and mild central aortic regurgitation ((Figure 1)E, Online Video 5). The patient was followed-up at 1 month, and repeat transthoracic echocardiogram and cardiac computed tomography showed excellent percutaneous bioprosthetic valve deployment (Figure 1F). This case illustrated the feasibility of using a valve-in-valve PAVR procedure for treatment of severe paravalvular aortic regurgitation.