An 81-years-old gentleman was referred to our center for symptomatic structural degeneration causing severe regurgitation of a 23-mm aortic Carpentier-Edwards bioprosthesis heart valve (BHV). The patient suffered from severe chronic kidney disease with an estimated glomerular filtration rate of 17 ml/min/1.73 m ² . Sinus rhythm with right bundle branch block was recorded at admission. A pre-procedural computed tomography, performed without contrast, demonstrated the low risk of coronary obstruction ( Fig. 1 .A), whereas a peripheral vascular ultrasound revealed iliac and femoral arteries diameters compatible with a trans-femoral procedure (>5.5 mm). On these basis, after Heart Team evaluation, the patient was deemed eligible for a contrast-zero trans-catheter aortic valve-in-valve (ViV) replacement. To minimize the risk of high residual trans-valvular gradient, a 26-mm self-expanding Hydra (Sahajanand Medical Technologies Limited) trans-catheter heart valve (THV) was chosen. This novel supra-annular THV is made up by a nitinol frame with large cells (≥15 Fr, ideal to preserve coronary re-access) and a three-tentacle design at the outflow tract. Bovine pericardium leaflets are attached to the stent by three commissures, placed at tentacles' bases ( Fig. 1 .B). The ventricular inflow of the THV is tubular, potentially reducing the risk of irreversible conduction system damage [1] . An ultrasound-guided puncture was used to obtain the right arterial femoral access, inserting an 18-Fr DrySeal sheath (Gore). The Hydra THV was then advanced in the ascending aorta. At that point, proper commissural alignment was confirmed adopting the right-left coronary cusp overlap view and visualizing the “near 1:2 pattern” of the marker's rows [2] . The Hydra THV was then aligned for the implant, positioning the lowest row of its radiopaque markers just below the BHV ring. Under rapid pacing, the THV was slowly released obtaining a final good position without contrast dye injection ( Online Video 1 ). No recapture was needed. After complete THV deployment, we observed the absence of residual trans-prosthetic gradients ( Fig. 1 .C-D), without the need of post-dilatation. No further conduction disturbances were recorded and only trace of residual aortic regurgitation was demonstrated at trans-thoracic echocardiogram ( Fig. 1 .E and Online Video 2 ). Although contrast-zero trans-catheter aortic valve replacement has been already described with other self-expanding THVs [3] , this is the first case highlighting the possibility to use the novel Hydra THV in the complex setting of contrast-zero ViV-TAVR. The presence of peculiar features makes the Hydra a potential valuable choice in this scenario. In fact, the supra-annular design minimizes the risk of residual prosthesis-patient mismatch. Moreover, its recapturable nature, together with the presence of clear radiopaque markers, allows multiple and precise implantations without the need of transesophageal echo-guidance (“minimalistic” approach). Lastly, the possibility to achieve a proper commissural alignment, in association with the upper large cells, preserves coronary re-access.