Extremely early tricuspid bioprosthetic valve degeneration: Diagnostic evaluation and successful transcatheter valve-in-valve intervention

Structural valve degeneration (SVD) of bioprosthetic tricuspid valves within six months of implantation is exceedingly rare and presents significant management challenges. We describe the case of a bioprosthetic tricuspid valve failure occurring within two months of surgery, detailing the stepwise diagnostic evaluation and successful transcatheter tricuspid valve-in-valve (ViV) implantation. The successful transcatheter ViV approach demonstrates excellent technical feasibility with immediate hemodynamic improvement, confirming its role as a viable alternative to high-risk redo surgery in early valve failure. • Structural valve degeneration of a bioprosthetic tricuspid valve can occur as early as two months post-implantation, with transcatheter valve-in-valve replacement offering a safe and effective alternative to high-risk redo surgery in cases of early valve failure. • The structured diagnostic approach to early bioprosthetic valve failure must exclude endocarditis, leaflet thrombosis, and iatrogenic injury. • In the absence of extrinsic factors, intrinsic valve material defect should be considered as the etiology for rapid bioprosthetic degeneration.