A 78-year-old female patient presented with a degenerated surgical aortic bioprosthesis (Mitroflow 21 mm Valve, Sorin, Italy) causing symptomatic heart failure (New York Heart Association—NYHA—class III) and was scheduled for a transcatheter aortic valve in valve implantation after Heart Team discussion. To prevent the risk of left coronary artery obstruction, a bioprosthetic aortic scallop intentional laceration to prevent iatrogenic coronary obstruction (BASILICA) procedure of the left coronary cusp of the bioprosthesis was performed. After implantation of a 23 mm Evolut R transcatheter bioprosthesis (Medtronic), since the residual mean aortic transvalvular gradient was high (20 mmHg), bioprosthetic valve fracture (BVF) was performed to reduce it to 10 mmHg. The patient improved to NYHA I and remained stable at the 16 months follow-up.