The patient MR D.S.D. is a 87 yrs male with diabetes, hypertension & hypothyroidism; he underwent coronary bypass surgery in 1987 and second bypass surgery in 2001. He was asymptomatic till few months back when he started complaining of severe breathing difficulty while walking and bilateral lower limb swelling, the sign of congestive heart failure. Transoesophageal echocardiographic evaluation showed non-coaptation of septal and posterior leaflet with massive tricuspid regurgitation along with moderately severe mitral regurgitation with preserved systolic function of both left and right ventricle and moderate pulmonary hypertension. He was optimised on medical therapy for 3 months without much improvement in symptomatic status. In view of his age and previous heart surgeries he was considered high risk for another heart surgery. Considering the risk benefit ratio multidisciplinary team at Medanta opted for a non invasive treatment for leakage in mitral and tricuspid valve with the MitraClip valve repair technology for treating both the heart valves. Mitra clip treatment is a standard procedure for surgical high risk patients of Mitral regurgitation with suitable anatomy. Medanta is among the top few centres doing highest number of MitraClip procedures. This is a case where we have used MitraClip for treating two different valves of heart simultaneously the mitral and the tricuspid valve for the first time in India and southeast Asia. Using MitraClip for tricuspid position is technically demanding procedure as the clip is designed for mitral valve only and the dedicated tricuspid valve clip is not available in India. Tricuspid regurgitation is a condition that occurs when the tricuspid valve in the heart fails to close properly, leading to blood flowing back into the right atrium. This along with mitral regurgitation can cause a congestive cardiac failure with symptoms of both left and right sided heart failure and can be life threatening if not treated in time. Tricuspid Clipping treatment by using Mitra clip is a new, minimally invasive procedure that has shown promising results in treating tricuspid regurgitation. During the procedure, a small clip is placed on the leaflets of the tricuspid valve to help it close properly. Using MitraClip simultaneously for both leaking valves is a unique example of advancement in non surgical valve therapies at Medanta the Medicity. Unlike traditional surgeries, mitral valve and Tricuspid valve Clipping treatment does not require the chest to be opened up, and recovery times are much shorter. Mitral valve repair using MitraClip system is a standard procedure & studies have shown that the procedure is safe and effective, with many patients experiencing significant improvements in their symptoms of mitral regurgitation. While Tricuspid Clipping treatment is still a relatively new procedure, it has the potential to greatly improve the lives of those suffering from tricuspid regurgitation. The procedure was performed under general anaesthesia by a team of doctors from Medanta lead by Dr Praveen Chandra and Dr Nagendra Chouhan and were navigated by the help of advanced three dimensional echocardiographic imaging by Dr Manish Bansal along with a team of cardiac anaesthetists. The procedure was done in hybrid operation theatre with Dr Naresh Trehan’s team stend by if needed. The procedure was completed in two hours with placement of one clip in the mitral position to treat the moderately severe mitral regurgitation while three clips were required for the massive tricuspid regurgitation. The Patient was extubate on same day and stabilized for next few days and discharged for hospital on 3rd post procedure day with two valves repaired without and surgery and is able to walk home with significant improvement in his symptoms.