Bioprosthetic valve fracture (BVF) as an adjunct to valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 and SAPIEN 3 Ultra valves is associated with a higher risk for in-hospital mortality and significant bleeding, with modest improvements in echocardiography-derived hemodynamic status, and the timing of BVF is a key factor in the procedure’s safety and efficacy, new study results show.