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Updated: Mar 16, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Transapical Mitral Valve-in-Valve Replacement in Patient With Previous Complex Sternal Reconstruction
Conor F Hynes1, Omid Fatemi, Aditya C Sharma
1From the *Division of Cardiothoracic Surgery, Veterans Affairs Medical Center, Washington, DC USA; †Division of Cardiology, The George Washington University, Washington, DC USA; ‡Division of Cardiology, Veterans Affairs Medical Center, Washington, DC USA; and §Division of Cardiothoracic Surgery, The George Washington University, Washington, DC USA.
Abstract:
We present a complex case of a transapical redo mitral valve-in-valve replacement. Repeat mitral valve replacement was indicated for severe symptomatic bioprosthetic stenosis. In addition to the patient's numerous comorbidities that included diabetes, hepatic cirrhosis, ischemic cardiomyopathy, and atrial flutter, he had undergone a previous open mitral valve replacement that was complicated by sternal dehiscence requiring extensive chest wall reconstruction. Transapical approach was performed through left minithoracotomy incision with balloon-expandable valve. Transapical valve-in-valve replacement of a stenotic mitral bioprosthesis is a viable solution in a patient with previous complex chest wall reconstruction and multiple comorbidities.
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