Successful staged percutaneous transvalvular implantation in multivalvular heart disease.

A woman underwent two mitral valve replacements and a tricuspid bioprosthesis surgery (1977 and 1988) for rheumatic disease. At 61 years old (2012), despite diuretics, right heart failure occurred, due to a severe tricuspid bioprosthesis stenosis, with a preserved LV fraction, good mechanical mitral prosthesis function but a moderate aortic stenosis (AS). [...