{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:22:04Z","timestamp":1787548924566,"version":"build-2736575974"},"reference-count":6,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Using a high\u2010pressure balloon to do bioprosthetic valve remodeling (BVR) for a failed surgical non\u2010fracturable aortic valve is thought to improve the expansion of a transcatheter heart valve (THV) during valve\u2010in\u2010valve transcatheter aortic valve replacement (ViV\u2010TAVR). However, the risks and benefits of this approach remain under debate. We present two cases of failed bioprosthetic aortic valves (Trifecta 19\u2009mm and 21\u2009mm, Abbott Vascular) receiving ViV\u2010TAVR\u00a0using balloon\u2010expandable valves (Sapien 3 20\u2010mm, Edwards Lifesciences). In one patient, an ATLAS GOLD balloon catheter (20\u2009mm, BD, Franklin Lakes, New Jersey, USA) was used to do BVR. In the other patient, a double\u2010tap technique with the same volume balloon post\u2010dilatation was performed without BVR. Both procedures were successful, with notable clinical improvement. The post\u2010TAVR computed tomography and transthoracic echocardiogram were performed 1 month after the procedure which demonstrated comparable hemodynamic results; however, the THV deformation was more pronounced in the patient who underwent BVR. Importantly, the THV\u2010to\u2010coronary ostium distance in this patient decreased unexpectedly from 5\u2009mm to near 0\u2009mm over right coronary artery. These cases illustrate that using a high\u2010pressure balloon to perform BVR in a non\u2010fracturable surgical valve had limited impact on THV expansion at the annular level. Conversely, unpredictable over\u2010expansion of the THV in the outflow portion may pose an increased risk to the coronaries, even when the valve\u2010to\u2010coronary distance is long prior to the valve\u2010in\u2010valve TAVR procedure.<\/jats:p>","DOI":"10.1002\/ccd.70830","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:15:33Z","timestamp":1787548533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Remodel the Failed Trifecta or Not: That Is a Question"],"prefix":"10.1002","author":[{"given":"Yi\u2010Lin","family":"Tsai","sequence":"first","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9871-6514","authenticated-orcid":false,"given":"Ching\u2010Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su\u2010Chan","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6402-0754","authenticated-orcid":false,"given":"Chun\u2010Chin","family":"Chang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai\u2010Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Surgery National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiao\u2010Po","family":"Hsu","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Surgery National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Hsien","family":"Sung","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1161\/CIRCULATIONAHA.121.058339","article-title":"Deformation of Transcatheter Aortic Valve Prostheses: Implications for Hypoattenuating Leaflet Thickening and Clinical Outcomes","volume":"146","author":"Fukui M.","year":"2022","journal-title":"Circulation"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"e1159","DOI":"10.4244\/EIJ-D-25-00258","article-title":"Routine Post\u2010Dilatation at Nominal Volume to Optimise the Expansion of Balloon\u2010Expandable Valves: The Double\u2010Tap Study","volume":"21","author":"Husain A.","year":"2025","journal-title":"EuroIntervention"},{"issue":"3","key":"e_1_2_14_4_1","article-title":"Balloon\u2010 Versus Self\u2010Expanding Transcatheter Valves for Failed Small Surgical Aortic Bioprostheses: 3\u2010Year Results of the LYTEN Trial","volume":"19","author":"Cepas\u2010Guill\u00e9n P.","year":"2026","journal-title":"Circulation: Cardiovascular Interventions"},{"key":"e_1_2_14_5_1","first-page":"2999","article-title":"Balloon\u2010 vs Self\u2010Expanding Transcatheter Valves for Failed Small Surgical Aortic Bioprostheses","volume":"16","author":"Nuche J.","year":"2023","journal-title":"JACC: Cardiovascular Interventions"},{"key":"e_1_2_14_6_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.shj.2023.100276","article-title":"New Insights and Perspective on Bioprosthetic Valve Fracture From Bench Testing and Computed Tomography Analysis","volume":"8","author":"Hashimoto G.","year":"2024","journal-title":"Structural Heart"},{"key":"e_1_2_14_7_1","first-page":"1594","article-title":"Bioprosthetic Valve Remodeling in Nonfracturable Surgical Valves","volume":"16","author":"Meier D.","year":"2023","journal-title":"JACC: Cardiovascular Interventions"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70830","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70830","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70830","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:15:34Z","timestamp":1787548534000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":6,"alternative-id":["10.1002\/ccd.70830"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70830","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70830"}}