Key Points Disadvantages of existing balloon expandable or self‐expanding transcatheter platforms for mitral valve‐in‐valve include the potential for malposition during deployment and for LV outflow tract obstruction Controlled mechanical valve expansion, the option to reposition, and stable hemodynamics throughout the procedure make the LOTUS valve an attractive option for mitral valve‐in‐valve Correct sizing remains a critical aspect of all trancatheter valve implant procedures, including valve‐in‐valve implants