In this podcast, Editor-in-Chief Jian'an Wang discusses the ongoing debate over patient-prosthesis mismatch (PPM) following transcatheter aortic valve replacement (TAVR), highlighting conflicting findings between Western and Asian cohorts. Recent data from the updated Ocean TAVR registry suggests that severe PPM is an independent risk factor for long-term mortality and rehospitalization, underscoring the need for personalized device selection to improve outcomes, particularly in patients with smaller annuli and larger body surface areas.