Transapical mitral valve-in-valve implantation for patients in cardiogenic shock.

Transcatheter aortic valve implantation has demonstrated excellent results in high risk and inoperable patients, and been extended to valve-in-valve implantation for those with prosthetic aortic and, more recently, mitral valve failure. Despite its use in high risk and inoperable patients, active cardiogenic shock has historically been considered a contraindication. We describe 2 patients in acute cardiogenic shock from prosthetic mitral valve failure treated with transcatheter mitral valve-in-valve implantation. Transcatheter mitral valve therapies should be considered in patients in cardiogenic shock from prosthetic mitral valve failure, although, larger studies are needed to make any strong recommendation.