Introduction
Surgical mitral valve replacement has been the mainstay treatment for degenerated bioprosthesis. However, the transcatheter valve-in-valve procedure is increasingly recognized as an alternative treatment in selected patients. 1 Moreover, percutaneous valve technology continues to evolve, making these valves available for use in a broader population. 1 In 2017, the American Heart Association/American College of Cardiology updated its guidelines for management of patients with valvular heart disease, changing the word “reoperation” to “reintervention” to account for transcatheter valves. 2 However, although bioprosthetic valves have shown good reliability in older patients, they degenerate more quickly in younger patients, presumably because of the increased contractility and valve stress among those with increased activity.3 We present a case involving a 13-year old female who received a transcatheter valve for degenerated mitral bioprosthesis with 30 months of follow up. To the best of our knowledge, this is the youngest patient to undergo this procedure.