Bioprosthetic aortic valve replacement on a mechanical valve ring

Mechanical valve failure is a known but rare occurrence in cardiac surgery. A 71-year-old lady underwent surgery for failure of her mechanical aortic valve. It was replaced with another mechanical valve. However, during operative manipulation, both leaflets fractured, resulting in a prolonged operative time. Under these circumstances, a novel approach was adopted and a bioprosthetic valve was implanted on the mechanical valve sewing ring as a final resort. The intervention was successful. This illustrates a case of the need for innovative approaches in cardiac surgery.