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A 80-year-old female patient presented with dyspnea intractable to medical therapy. She received surgical mitral valve replacement with Hancock II (Medtronic, Minneapolis, MN, USA) (Figure 1) 27 mm bioprosthetic valve 11 years ago due to severe rheumatic mitral stenosis. Other comorbidities included atrial fibrillation, stroke, and restrictive lung disease. The echocardiography showed a prolapse of bioprosthetic mitral valve posterior leaflet with severe eccentric mitral regurgitation (MR) accompanied by severe resting pulmonary hypertension. The multi-detector computed tomography (MDCT) showed the degenerative change of mitral bioprosthetic valve with posterior leaflet prolapse.

Transseptal Transcatheter Mitral Valve-in-valve Replacement for a Failed Bioprosthetic Mitral Valve