The regurgitation of the native aortic valve in patient with previous David operation may represent a clinical challenge because the morbidity and mortality risk of re-operation is not negligible. Here we describe the case of a patient suffering from late severe aortic regurgitation, many years after David operation, efficaciously treated with transfemoral transcatheter aortic valve implantation. To the best of our knowledge, this is the first description of such treatment in a patient with aortic regurgitation and previous David operation. •David operation is frequently used in patients with aortic root pathology and normal aortic valve•Despite the favourable mid-term outcome, during the late follow-up regurgitation of the native aortic valve may develop•The morbidity and mortality risk of re-operation is not negligible•We describe the case of a patient with aortic regurgitation after David operation, treated with transfemoral TAVI.•To the best of our knowledge, this is the first description of such TAVI in a patient with previous David operation