We present the case of a 6-month-old girl with a congenital heart disease consisting in severe mitral valve stenosis, severe aortic coarctation and hypoplasia of the transverse aorta and the isthmus. She was taken to surgery at 4-months of age for a reconstruction of the aortic arch, mitral valvuloplasty, and creation of a calibrated 5 – mm interatrial communication. She developed early failure of the valvuloplasty with stenosis and severe residual mitral regurgitation, and progressed to severe acute heart failure. It was decided to implant a pulmonary Medtronic Melody 22 mm valve in the mitral position by a hybrid approach in collaboration with the pediatric hemodynamics group and cardiovascular surgery.