The limited durability of surgical bioprostheses, combined with an ageing population, has led to an increasing demand for replacing degenerated bioprosthetic surgical heart valves, which is projected to increase. Valve-in-valve transcatheter aortic valve implantation involves implanting a transcatheter heart valve within a degenerated bioprosthetic surgical heart valve. A significant minority of patients, however, are left with a suboptimal haemodynamic result with high residual gradients. This is more common with smaller surgical bioprostheses, and may be associated with a worse prognosis. The novel concept of fracturing the previously implanted bioprosthetic surgical heart valve during valve- in-valve transcatheter aortic valve implantation to create a more favourable haemodynamic profile has shown great promise, particularly in smaller valves. Herein, we describe the benefits, limitations and potential complications of this novel approach.