Structured Abstract Background Besides transcatheter edge-to-edge repair (TEER) there are new interventional treatment options for mitral and tricuspid regurgitation in evaluation, such as a complete replacement of the valve through a prosthesis. Case summary A 78-years-old previous coronary artery bypass graft-operated patient with symptomatic severe mitral regurgitation and tricuspid regurgitation was sequentially treated by a transfemoral transcatheter mitral and tricuspid valve prosthesis (Cardiovalve; Cardiovalve Ltd, Israel) due to unfavorable mitral valve anatomy. The transcatheter mitral valve implantation (TMVI) was performed first and after progression of the tricuspid regurgitation, a second transcatheter valve prosthesis was implanted in tricuspid position (TTVI) 1.5 years later. Imaging showed a twin look-alike picture of a mitral and tricuspid prosthesis and showing the possibility of a complete transcatheter based replacement of the mitral and tricuspid valve. Discussion This case shows the possibility of a Cardiovalve prosthesis being used for TMVI and TTVI in a single patient. Especially in TEER ineligible patients it might be a good treatment option after device approval. Conclusion A Cardiovalve prothesis can be used for TMVI and TTVI, especially in TEER ineligible patients and with one device for both anatomies, which might be a good treatment option after device approval.