Percutaneous aortic valve replacement represents a minimally invasive alternative to open heart valve replacement in high-risk patients. Interventional procedures are used in an increasing number of patients and indications are broadened as techniques further evolve. However, there are still many postulated contraindications for interventional aortic valve replacement. We report a case of successful transfemoral aortic valve replacement in a patient with a mechanical mitral valve, performed due to the patient's refusal to accept blood transfusions. The feasibility and good procedural result may further extend future indications for interventional valve replacement.