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Langhammer, Florian; Lehner, Anja; Haas, Nikolaus A. and Jakob, André (2020): Percutaneous pulmonary valve implantation in a dysfunctional Trifecta® bioprothesis after high‐pressure balloon fracturing. In: Catheterization and Cardiovascular Interventions, Vol. 95, No. 7: pp. 1310-1313 [PDF, 1MB]


A percutaneous pulmonary valve‐in‐valve (PPVIV) implantation in small surgical tissue valves may be limited due to the valve's initial diameter. Fracturing of the valve's integrity by high‐pressure balloons may enhance the diameter and facilitate subsequent PPVIV with a large valve. To the best of our knowledge, the Trifecta® valve seemed not to be accessible for fracturing. We report a case of successful 19‐mm Trifecta valve fracturing, followed by PPVIV using a 26‐mm Edwards SAPIEN 3 valve in pulmonary position. By repetitively using a high‐pressure balloon 5 mm larger than the labeled valve size, we were able to fracture the valve's integrity and implant a 26‐mm valve thereafter. Therefore, Trifecta valve appears to be suitable for valve ring fracturing and subsequent PPVIV in certain patients.

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