Pulmonary hypertension (PH) is a complex and progressive disorder characterised by elevated pulmonary artery pressure. It is a serious condition that can significantly impair quality of life and lead to fatal cardiovascular complications if left unmanaged. Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgical procedure that has revolutionised the treatment of severe aortic stenosis (AS). However, the presence of PH in patients undergoing TAVI has been identified as a critical factor that can influence clinical outcomes, both in the short and long terms.

In 2022, the most recent update of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) guidelines for PH presented a redefinition of the haemodynamic criteria for its diagnosis.1 These new guidelines lowered the mean pulmonary artery pressure (mPAP) threshold and introduced new pulmonary vascular resistance (PVR) cut-offs. While these modifications allowed for the earlier detection of PH, they also recategorised many patients, making it challenging for clinicians to understand the implications of these changes in real-world practice. The paper under discussion presents an important advancement in this context. The application of the newer guidelines to patients with AS undergoing TAVI provides valuable insights into the implications of these changes, with potential significant impact on patient management. While previous studies have evaluated the prevalence of PH in this patient population, few have thoroughly investigated the impact of the new criteria on prognosis, patient selection and …