Significant underexpansion was consistently observed after deployment of balloon-expandable transcatheter valves in this prospective analysis. Published in JACC: Cardiovascular Interventions, the report evaluated whether routine post-dilatation could optimize frame geometry and support early hemodynamic outcomes.

The investigation included 200 adults undergoing transcatheter aortic valve implantation for native aortic stenosis. All individuals underwent routine post-dilatation, and frame measurements were obtained before and after the procedure using fluoroscopy. Marked underexpansion was seen at the mid-frame level, and post-dilatation produced substantial improvement in expansion and expected foreshortening.

Short-term outcomes were favorable. At 30 days, all-cause mortality was 1.5%, stroke occurred in 3.0%, the mean gradient remained low at 10.7 ± 4.2 mmHg, and no patient demonstrated more than mild paravalvular leak.

These findings suggest that routine post-dilatation can improve early structural and functional performance of balloon-based TAVR systems. Longer-term studies will be necessary to determine its impact on durability and late hemodynamics.