A 26-year-old Japanese woman experienced threatened cardiac rupture after mitral valve replacement and debridement of a left ventricular (LV) posterior wall abscess caused by infectious endocarditis. We performed cardiac autotransplantation using the bicaval technique to allow bench repair of the recurrent abscess. A balloon catheter was inflated in the inferior vena cava to obtain a bloodless anastomotic field. This is the first report of autotransplantation for threatened LV rupture after posterior wall repair.