Is it really “paradoxical” or just the ventricle?

• Patients with paradoxical low flow low gradient (PLFLG) aortic stenosis (AS) have favorable mid‐term outcomes after transcatheter aortic valve replacement (TAVR). These outcomes were comparable to those patients with high gradient AS (HGAS).
• Clinicians should avoid delaying referral of patients with PLFLG AS for valve replacement for either surgical aortic valve replacement (SAVR) or TAVR.
• Further studies are need to understand the increased early mortality after TAVR in PLFLG AS compared to HGAS, and to determine whether improvements of TAVR procedural techniques can result in better outcomes.