SCT may be a viable option for selected patients with GT. However, SCT in GT carries its own significant risks, resulting from the development of anti-platelet antibodies. A critical risk-benefit analysis is mandatory prior to SCT.
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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