title: Cracking a tricuspid perimount bioprosthesis to optimize a second transcatheter sapien valve-in-valve placement.
abstract: Bioprosthetic valves degenerate over time. Transcatheter valve-in-valve procedures have become an attractive alternative to surgery. However, every valve increasingly diminishes the diameter of the valvar orifice. We report a 12-year-old female who had a previous transcatheter tricuspid valve-in-valve procedure; cracking the ring of a Carpentier Edwards Perimount valve by means of an ultrahigh pressure balloon allowed implantation of a further larger percutaneous valve. The advantage of this novel approach permits enlarging the inner valve diameter and may facilitate future interventions and prolong time to surgery. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Fetal and Pediatric Cardiology, University Hospitals Leuven, Belgium.|Pediatric Cardiology, University of the Free State, South Africa.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Brown
authors.affiliation: Fetal and Pediatric Cardiology, University Hospitals Leuven, Belgium.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Cools
authors.affiliation: Fetal and Pediatric Cardiology, University Hospitals Leuven, Belgium. marc.gewillig@uzleuven.be.
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
mesh_terms: D063126:Balloon Valvuloplasty; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D002648:Child; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D011312:Pressure; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015641:Radiography, Interventional; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D014264:Tricuspid Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*
keywords: cracking; percutaneous; ultrahigh pressure balloon; valve-in-valve