Abstract
This case report describes an 82-year-old woman with severe mitral bioprosthesis stenosis and NYHA II-III heart failure, EuroScore II of 22.54% and STS Score of 13.7%. She received innovative treatment with transatrial mitral valve-in-valve implantation of a rapid deployment balloon-expandable prosthesis via video-assisted right lateral mini-thoracotomy, with myocardial protection through ventricular fibrillation. The patient was discharged and, under cardiology follow-up, achieved NYHA I class with no angina.