Abstract: Transcatheter mitral valve replacement is provided which includes a stabilizing stent portion for placement at a mitral annulus, with a narrowed waist portion to avoid significantly dilating the annulus, and expanded bulb portions at the atrial and ventricular ends to secure the device in position. A housing is attached to the stabilizing stent and reduces in diameter to a smaller tract portion where replacement valve leaflets are secured. The resulting smaller replacement mitral valve offers benefits including a lower introduction profile, yet fits and secures to the native annulus by the securing stent and housing. Expansion limiting elements can limit expansion of portions of self-expanding stent if desired, avoiding excessive mitral annulus dilation or providing a fixed diameter in other portions of the stent or housing. Two-step implantation can be accomplished by making the housing functional as a temporary valve.