Abstract
Post-surgical deterioration of mitral valve repairs or replacements may present a clinical dilemma due to the high-risk nature of repeat surgery. Recent advances in transcatheter techniques and surgery have enabled the implantation of balloon-expandable valves in the mitral position when surgical rings and valves are present. Valves may be implanted either via transseptal or transapical access, with a reported success rate between 88-100 %.