Singapore Med J 2020, 1–7

Chiam PT, Lim Choon Pin, Lim YT, Sivathasan C.

Transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR) has become a treatment option for patients with severe aortic valve stenosis who are inoperable or at high and intermediate surgical risk.
(1) Transcatheter aortic valve-in-valve replacement for degenerated surgical aortic bioprostheses has also become an established, less invasive alternative to redo open aortic valve replacement.
(2) Transcatheter mitral valve-in-valve replacement has been employed in smaller numbers for degenerated mitral bioprostheses.
(3) To our knowledge, our case is the initial experience in Southeast Asia of percutaneous transfemoral transcatheter mitral valvein-valve replacement for a failed surgical mitral bioprosthesis, with nine months’ follow-up.

A 64-year-old obese man was referred to our institution for exertional dyspnoea (NYHA [New York Heart Association] Class III) and orthopnoea of 3–4 months’ duration. His past medical history included chronic renal failure (serum creatinine ~400 µmol/L), diabetes mellitus, hypertension, dyslipidaemia and rheumatic heart disease with mitral valve replacement (27-mm Carpentier-Edwards PERIMOUNT Magna bioprosthesis [Edwards Lifesciences, Irvine, CA, USA]) 9.5 years prior to the current presentation.