Novel Use of Valve-in-Valve Transcatheter Mitral Valve Replacement for Severe Bioprosthetic Mitral Valve Stenosis During Pregnancy: A Case Report.

A 26-year-old woman at 14 weeks gestation with her third pregnancy presented with severe bioprosthetic mitral valve stenosis, which represents very high maternal and fetal risk. Pregnancy termination was recommended but declined, and valve surgery was deemed to be of prohibitive risk. After multidisciplinary discussion, she underwent valve-in-valve transcatheter mitral valve replacement in the second trimester. She had an uncomplicated vaginal delivery at term. This represents a novel use of transcatheter valve replacement to stabilize a pregnant patient with a high-risk valvular lesion. This approach may be considered after multidisciplinary discussion in appropriately selected patients.