Balloon occlusion of the inferior cava vein to prevent valve prolapse for transjugular tricuspid valve-in-valve

Transcatheter valve-in-valve implantation has emerged as a viable alternative for treating degenerated bioprosthetic tricuspid valves. However, patients with Ebstein's anomaly, characterized by an enlarged right atrium, pose challenges due to difficulties in correct positioning and deployment of transcatheter valves, stemming from inadequate support and coaxial alignment. In our presented case report, we describe a tricuspid valve-in-valve procedure performed on a patient with Ebstein's anomaly and a significantly enlarged right atrium. A novel technique was employed to facilitate the advancement of the transcatheter heart valve within the degenerated bioprosthesis, ultimately ensuring the success of the intervention.