Valve-in-Chimney Mitral Valve Replacement for Extensive Annular Calcification.

Mitral annular calcification poses notable challenges for mitral valve replacement, especially in patients with small annular orifices. We present a case of a 69-year-old woman with severe mitral annular calcification and mitral stenosis, successfully treated using a valve-in-chimney technique. This approach minimized calcium debridement and enabled secure bioprosthesis placement larger than that which could have been placed with other options.