This roundtable — supported by Edwards Lifesciences — gathers leading interventional cardiologists to discuss the evolving landscape of transcatheter therapies for mitral regurgitation (MR) and tricuspid regurgitation (TR). It reviews when to opt for repair vs replacement, shares clinical experiences with newly approved systems, and outlines how innovations are broadening candidacy and improving outcomes for patients who previously had limited options. Key topics include first-commercial use of the transseptal mitral valve replacement system, and emerging tricuspid valve replacement devices, underscoring a shift toward more robust and flexible treatment strategies in structural heart disease.