Abstract
In presence of a heavily calcified mitral apparatus, mitral valve replacement may represent a challenging surgical intervention. The risk of injury to the atrioventricular groove is high and the success rate of its consequent repair is very low. Nevertheless, a symptomatic patient affected by severe mitral stenosis, especially when balloon commissurotomy is not indicated, should not be left untreated. Mitral decalcification represents a risky option, but an apparently simpler and safer solution can be an open-heart positioning of an inverted aortic balloon-expandable aortic prosthesis.
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