Redo multiple valve replacement is known to carry additional risk of
morbidity and mortality. Currently, a transcatheter-based valve-in-valve
approach could be useful in reducing potential serious consequences. On
the other hand, this approach poses several technical challenges
regarding the device and procedural aspects of the procedure. We present
the case of a 78-year-old man who presented with symptoms of heart
failure due to mitro-aortic bioprosthesis degenerations who was deemed
to be at extremely high risk for conventional redo surgery. A two-steps
single admission transcatheter-based approach was planned with a
transfemoral aortic valve-in-valve procedure followed by a trans-apical
mitral valve-in-valve implantation. The outcome was good and the
recovery was fast.