Introduction
Re-interventions for degenerated bioprosthetic valves are known to carry additional risk of postoperative morbidity and mortality; in elderly patients aged > 75 years this is particularly evident with an estimated postoperative risk of mortality that may exceed 10%. [1]
Transcatheter procedures have proven to be a safe alternative to conventional redo cardiac surgery in complex redo cases although they pose additional challenges especially in the setting of valve-in-valve deployment due to the close anatomical relationships of the mitro-aortic valves.
We report a successful two-steps valve-in-valve procedure for the replacement of failed mitro-aortic bioprosthesis.