Discrepancy between catheter and doppler gradients immediately post transcatheter aortic valve replacement in an underexpanded prosthesis

Underexpansion of an aortic bioprosthetic valve is common after transcatheter aortic valve replacement (TAVR). Significant discrepancy between invasive hemodynamic gradients and echocardiographic Doppler gradients in an underexpanded bioprosthesis can be attributed to pressure recovery phenomenon. This case emphasizes the importance of echocardiographic guidance in implantation and assessment of bioprosthetic valve during TAVR.