We describe a human transcatheter transapical mitral valve implant within a mitral bioprosthesis (valve-in-valve). A high-risk, 80-year-old man with symptomatic bioprosthetic mitral stenosis was positioned for anterior minithoracotomy. Left ventricular apical access was obtained. After balloon valvuloplasty, a cuffed, 26-mm Cribier-Edwards transcatheter valve (Edwards Lifesciences LLC, Irvine, CA) was deployed within the mitral xenograft, using rapid ventricular pacing. The transcatheter valve functioned properly postoperatively; however, the patient died of multiple organ dysfunction.