Replacing the mitral valve alone does not completely fix the heart!

TMVR for degenerative (stenosis and regurgitation) mitral valve prosthesis (valves and rings) results in immediate and sustainable reduction but not normalization of left atrial pressure. Concomitant comorbid conditions such as left ventricular diastolic dysfunction adversely impact left atrial pressure and should be treated. The long-term impact of postprocedural ASD and patient-prosthesis mismatch need to be systematically evaluated so we develop the appropriate data to guide decision making as more transeptal mitral procedures are being performed.