{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:10:01Z","timestamp":1756275001880,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,14]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>The Trifecta tissue valve (Abbott, Illinois, USA) is an externally mounted bovine pericardial aortic valve (AV) prosthesis with adequate haemodynamic performance and better early results than another option. However, concerns have been raised about its durability. Recently, reports have emerged about an increased incidence of early structural valve failure after Trifecta implantation, where leaflet tear(s) with dehiscence along the stent post was the primary mode of early failure. In this article, we present the case of a patient in her 70s, 7 years after AV replacement with a Trifecta valve, who developed progressive dyspnoea. Physical examination revealed signs of chronic severe aortic regurgitation (AR). The initial transthoracic echocardiogram showed severe transvalvular AR, but the aetiology could not be determined. Cardiac computed tomography (CT) revealed a flail non-coronary cusp of the Trifecta bioprosthetic valve without vegetation. After discussion, we concluded that our patient was suitable for valve-in-valve transcatheter aortic valve replacement (ViV TAVR).<\/jats:p>","DOI":"10.1136\/bcr-2023-256369","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T11:50:45Z","timestamp":1708689045000},"page":"e256369","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unusual cause of severe transvalvular eccentric jet AR: early structure valve deterioration of Trifecta valves by flail leaflet undergoing valve-in-valve transcatheter aortic valve replacement"],"prefix":"10.1136","volume":"17","author":[{"given":"Thirath","family":"Chatlaong","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9257-2051","authenticated-orcid":false,"given":"Paisit","family":"Kosum","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monravee","family":"Tumkosit","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thitima","family":"Limjareon","sequence":"additional","affiliation":[{"name":"Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"2025082622513592000_17.2.e256369.1","unstructured":"Abbott Trifecta Valves: Potential Risk of Early SVD. Abbott Trifecta Valves: Potential Risk of Early Structural Valve Deterioration- Letter to Health Care Providers | FDA 2023, Available: https:\/\/www.fda.gov\/medical-devices\/letters-health-care-providers\/abbott-trifecta-valves-potential-risk-early-structural-valve-deterioration-letter-health-care"},{"key":"2025082622513592000_17.2.e256369.2","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/j.athoracsur.2020.07.040","article-title":"Durability and performance of 2298 Trifecta aortic valve Prostheses: a propensity-matched analysis","volume":"111","author":"Yongue","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2025082622513592000_17.2.e256369.3","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.athoracsur.2019.12.071","article-title":"Laakso T et al.Trifecta versus Perimount Magna ease aortic valve Prostheses","volume":"110","author":"Biancari","year":"2020","journal-title":"The Annals of Thoracic Surgery"},{"key":"2025082622513592000_17.2.e256369.4","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.athoracsur.2019.06.032","article-title":"Early structural valve degeneration of trifecta bioprosthesis","volume":"109","author":"Fukuhara","year":"2020","journal-title":"The Annals of Thoracic Surgery"},{"key":"2025082622513592000_17.2.e256369.5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.athoracsur.2019.05.073","article-title":"Early first-generation Trifecta valve failure: a case series and a review of the literature","volume":"109","author":"Kaneyuki","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2025082622513592000_17.2.e256369.6","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.athoracsur.2018.12.036","article-title":"Excessive Pannus overgrowth on the aortic side of Trifecta valve causing severe regurgitation","volume":"108","author":"Schaefer","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2025082622513592000_17.2.e256369.7","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.jtcvs.2017.05.044","article-title":"Early Trifecta valve failure: report of a cluster of cases from a tertiary care referral center","volume":"154","author":"Kalra","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025082622513592000_17.2.e256369.8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/icvts\/ivaa236","article-title":"Structural valve deterioration after aortic valve replacement with the Trifecta valve","volume":"32","author":"Werner","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025082622513592000_17.2.e256369.9","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1016\/j.athoracsur.2020.11.026","article-title":"Velissaris T et Al.Premature structural failure of Trifecta Bioprosthesis in Midterm follow-up: a single-centre study","volume":"112","author":"Kattach","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2025082622513592000_17.2.e256369.10","doi-asserted-by":"crossref","DOI":"10.1093\/icvts\/ivac086","article-title":"Modes of failure of trifecta aortic valve prosthesis","volume":"35","author":"Malvindi","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025082622513592000_17.2.e256369.11","unstructured":"Beliaev AM , Webster MWI , Greaves SC , et al . Title of the article. N Z Med J 2018;131."},{"key":"#cr-split#-2025082622513592000_17.2.e256369.12.1","doi-asserted-by":"crossref","unstructured":"Shah B , Haider S , Rawlins J , et al . 39\u2005Valve-in-valve transcatheter aortic valve implantation in trifecta aortic bioprostheses - a single centre experience. British Cardiovascular Society Virtual Annual Conference, 'Cardiology and the Environment', 7-10 June 2021","DOI":"10.1136\/heartjnl-2021-BCS.39"},{"key":"#cr-split#-2025082622513592000_17.2.e256369.12.2","doi-asserted-by":"crossref","unstructured":"June 2021:A34-5 doi:10.1136\/heartjnl-2021-BCS.39","DOI":"10.1136\/heartjnl-2021-BCS.39"},{"key":"2025082622513592000_17.2.e256369.13","doi-asserted-by":"crossref","first-page":"20","DOI":"10.15420\/icr.2017:29:1","article-title":"Bioprosthetic valve fracture during valve-in-valve TAVR: bench to bedside","volume":"13","author":"Saxon","year":"2018","journal-title":"Interv Cardiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-256369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:51:47Z","timestamp":1756273907000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-256369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,23]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/bcr-2023-256369"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-256369","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}