Intentional bioprosthetic tricuspid valve fracture to facilitate transcatheter valve-in-valve deployment

Brian Karahalios, John P. Breinholt, Stephen H. Little, C. Huie Lin

Research output: Contribution to journalArticle


While transcatheter valve-in-valve (ViV) implantation may reduce the number of lifetime surgical reinterventions in some patients with congenital heart disease, in other patients the bioprosthetic valve ring can lead to patient-prosthesis mismatch due to reduction of internal diameter if a transcatheter valve is implanted. A 49-year-old woman with multiple prior cardiac surgeries presented with heart failure due to bioprosthetic tricuspid valve stenosis. Initial predilation valvuloplasty suggested conventional ViV implant would produce patient-prosthesis mismatch, therefore, we intentionally fractured the bioprosthetic valve ring to facilitate optimal hemodynamics with implantation of a 29 mm transcatheter valve.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
StatePublished - Jan 1 2020


  • congenital heart disease
  • patient prosthesis mismatch
  • transcatheter valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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