Abstract
BACKGROUND: Transcatheter double valve replacement is an evolving strategy for managing combined mitral and aortic valve disease, particularly in patients with bioprosthetic valve degeneration. CASE SUMMARY: We report the case of an octogenarian with severe native mitral regurgitation and stenosis of a degenerated transcatheter aortic valve. Comorbid conditions, including extensive peripheral and coronary artery disease, limited conventional surgical and transcatheter access options. A tailored approach involving single-stage transapical implantation of a balloon-expandable aortic prosthesis and a dedicated mitral system resulted in favorable hemodynamic and clinical outcome. DISCUSSION: This case represents the first published use of dedicated transcatheter mitral device in combination with transcatheter-valve-in-transcatheter-valve replacement. It underscores the potential of fully catheter-based double valve therapy in challenging scenarios. TAKE-HOME MESSAGES: Transapical transcatheter double valve replacement offers a viable alternative to redo surgery in select patients. Procedural success hinges on imaging-guided planning and individualized device strategy.