{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:33:27Z","timestamp":1762868007769,"version":"3.40.5"},"reference-count":4,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T00:00:00Z","timestamp":1575331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Transcatheter heart valve implantation into degenerated bioprosthetic valves (ViV\u2010THV implantation) has become an established procedure for high risk patients. In general, paravalvular leak (PVL) is a contraindication for valve\u2010in\u2010valve\u2010TAVR (ViV\u2010TAVR). Herein, we report on a 81\u2010year\u2010old patient presenting with acute heart failure for a failing aortic bioprosthesis (Medtronic Mosaic 27\u2009mm). Intraoperative transesophageal echocardiography during urgent ViV\u2010TAVR revealed a PVL previously not detected. After transfemoral implantation of a 26\u2009mm\u2010Evolut\u2010R, balloon\u2010fracturing of the bioprosthetic ring was performed using a 24\u2009mm True Dilatation balloon for treatment of the PVL. Afterward, left ventricular to aortic peak\u2010to\u2010peak pressure gradient measured 2\u20134mmHg. Transesophageal echocardiography merely revealed trace PVL. Aortic root angiography showed no PVL. At discharge, echocardiography measured a transprosthetic mean gradient of 5mmHg detecting no PVL. Intentional ring\u2010fracturing of an aortic valve prostheses may prove not only to be effective in lowering transvalvular gradients after valve\u2010in\u2010valve\u2010TAVR, but may also be a tool to treat PVL alongside degenerated surgical aortic bioprostheses in certain patients.<\/jats:p>","DOI":"10.1002\/ccd.28644","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T14:42:46Z","timestamp":1575384166000},"page":"859-862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Successful treatment of a paravalvular leak with balloon cracking and valve\u2010in\u2010valve TAVR"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6886-3660","authenticated-orcid":false,"given":"Hendrik","family":"Ruge","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center, TUM INSURE (Institute for Translational Cardiac Surgery)  Munich Germany"},{"name":"German Heart Center Munich, Department of Cardiovascular Surgery TUM  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Erlebach","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center, TUM INSURE (Institute for Translational Cardiac Surgery)  Munich Germany"},{"name":"German Heart Center Munich, Department of Cardiovascular Surgery TUM  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eveline","family":"Lieberknecht","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center, TUM INSURE (Institute for Translational Cardiac Surgery)  Munich Germany"},{"name":"German Heart Center Munich, Department of Cardiovascular Surgery TUM  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00fcdiger","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center, TUM INSURE (Institute for Translational Cardiac Surgery)  Munich Germany"},{"name":"German Heart Center Munich, Department of Cardiovascular Surgery TUM  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312422"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.04.007"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005216"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.05.083"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.28644","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.28644","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.28644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T02:03:46Z","timestamp":1693965826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.28644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,3]]},"references-count":4,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/ccd.28644"],"URL":"https:\/\/doi.org\/10.1002\/ccd.28644","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2019,12,3]]},"assertion":[{"value":"2019-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}