Dear Editor,

Please find attached article titled “Transcatheter Mitral Valve-in-Valve-in-Valve Implantation: Implications of complex interventional technique and 3D echocardiography for valve-in-valve Paravalvular Leak” for publication in your journal. The content of this manuscript is original and the manuscript is not under consideration elsewhere. None of the manuscript contents have been previously published, and all authors have read and approved the manuscript, its content, and its submission to the journal. There are no conflicts of interest to disclose, including relationship to industry.

All authors have made significant contributions to the manuscript. SS formulated concept, design and content outline, analyzed and interpreted data, drafted manuscript, revised manuscript critically for important intellectual content and finalized approval of manuscript submission. PS contributed to content, manuscript draft and revision. AR contributed to manuscript drafting and revision. MA contributed to interpretation and analysis, manuscript draft and revision. GB contributed by advising on content and design, and critical review of manuscript. All authors finalized approval of manuscript submission.

Thank you for your kind consideration. We hope you will consider it of interest to your readers.

Sincerely,

Sankalp Sehgal, MD