Transapical valve-in-valve replacement of a stenosed prosthetic mitral valve in a critically ill patient with cardiogenic shock: a case report

Abstract

The burden of managing dysfunctional mitral prosthetic valve disease in the elderly population is increasing for those who cannot tolerate a redo sternotomy along with their multiple comorbid conditions. We report a critically ill elderly patient with a high surgical risk, multiple comorbid conditions, longstanding chronic lung disease, hepatic dysfunction, coagulopathy, acute kidney injury, fluid overload and presenting with cardiogenic shock who was initially rescued with veno-arterial extracorporeal membrane oxygenation and then underwent successful transapical mitral valve-invalve replacement. She survived the procedure and was successfully extubated in the ICU on postoperative day 2. She died on day 5 due to a suspected thrombotic state.