Abstract
Mitral valve-in-ring procedure can be an alternative to surgical valve replacement. Malposition or residual mitral regurgitation and need for a second transcatheter valve is more common in mitral valve-in-ring than in valve-in-valve procedure. This case reveals how the implantation of a second prosthesis was able to fix a significant residual mitral regurgitation due to mitral ring detachment, "closing" the free flow cage of the first prosthesis and avoiding mitral regurgitation through the ring detachment.
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