Acute postoperative bioprosthetic valve thrombosis is a rare complication with challenging treatment. We present two consecutive cases of patients with myocardial infarction and papillary muscle rupture requiring urgent surgical mitral valve replacement and venoarterial extracorporeal membrane oxygenation support. Both patients developed early postoperative bioprosthetic mitral valve thrombosis and were successfully treated with emergent transcatheter valve-in-valve replacement.