**Abstract**

We will review transcatheter mitral valve replacement (TMVR) and discuss this evolving cutting edge procedure in terms of types (valve in valve, valve in ring and valve in mitral annular calcification MAC), clinical indications, pre-procedural planning and value of pre-procedural imaging including computed tomography role, technical challenges encountered in these procedures, potential complications for each type of TMVR, and potential strategies to mitigate and avoid such complications, We will review the currently available devices dedicated for mitral valve replacement, with a summary of their preliminary data and early outcome results. We will also discuss knowledge gaps and ideas for future research.

**Keywords:** Transcatheter mitral valve replacement, valve in valve, valve in ring, valve in mitral annular calcification
