We reported a case of a 61-year-old female patient, six years status post her last cardiac surgery, who was admitted with a chief complaint of bilateral lower extremity edema for over a year, which had acutely worsened with associated chest pain for two days. The patient had a complex cardiac surgical history: 12 years prior, she underwent double valve replacement (aortic and mitral) plus tricuspid valvuloplasty for mitral valve prolapse with severe regurgitation and moderate-to-severe aortic regurgitation. Nine years ago, she underwent bioprosthetic mitral valve replacement and vegetation removal for prosthetic valve vegetation with severe regurgitation. Six years ago, she underwent a transapical transcatheter mitral valve replacement and mitral balloon valvuloplasty due to prosthetic mitral valve prolapse with severe regurgitation. Following evaluation during this admission, she successfully underwent a valve-in-valve transcatheter aortic valve replacement (ViV-TAVR). The patient had an uneventful postoperative recovery. This case report aims to explore the clinical strategy and application of the ViV-TAVR technique for managing bioprosthetic valve failure in patients with a history of complex valvular surgeries.
