Percutaneous pulmonary valve implantation in a dysfunctional Trifecta® bioprothesis after high-pressure balloon fracturing

Catheter Cardiovasc Interv. 2020 Jun 1;95(7):1310-1313. doi: 10.1002/ccd.28781. Epub 2020 Feb 19.

Abstract

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.

Keywords: Trifecta® valve; dysfunctional biological valve; interventional valve-in-valve implantation; prestenting.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Balloon Valvuloplasty*
  • Bioprosthesis*
  • Cardiac Catheterization / instrumentation*
  • Child
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery*
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Prosthesis Failure*
  • Pulmonary Valve / abnormalities
  • Pulmonary Valve / physiopathology
  • Pulmonary Valve / surgery*
  • Recovery of Function
  • Treatment Outcome