Bioprosthetic tricuspid valve stenosis as a sequela of infective endocarditis is extremely rare. We describe the case of a 29-year-old male patient with a history of intravenous drug use and two previous bioprosthetic tricuspid valve placements who presented with recurrent endocarditis and severe tricuspid stenosis. He was deemed extremely high risk for redo valve replacement surgery. Intracardiac ultrasound-guided balloon valvuloplasty was performed with good clinical outcome. We believe that interventional treatment of prosthetic valvular stenosis in the setting of endocarditis is a reasonable therapeutic choice when open surgical repair is associated with prohibitively high mortality. This can be performed either as destination therapy or as a bridge to valve replacement. The use of intracardiac ultrasound provided additive information to that obtained by transthoracic and transesophageal echocardiography.
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