Because technology for valvular replacement continues to evolve, we expect it to be further reaching in the applications for intermediate- to high-risk surgical candidates. Although the patient population for transcatheter aortic valve replacement has widened, it is still extremely rare in the pregnant patient. We report a case of a transcatheter valve-in-valve implantation in the second trimester of pregnancy. The patient experienced an excellent outcome after comprehensive coordination across multiple services. We discuss anesthetic considerations in the care of the pregnant patient for transcatheter aortic valve implantation.