Abstract: Mitral balloon valvuloplasty was first described in 1984 by Inoue. The procedure is routinely performed through femoral vein puncture and the mitral valve catheterization is through a transeptal puncture. We report a challeging situation where it has been performed a mitral balloon valvuloplasty using the transapical access in reason of patient´s contra-indication to mitral valve surgery associated to technical difficulties to perform mitral balloon valvuloplasty via transeptal access.