Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Shoji Satoshi, MD, welcome Futoshi Yamanaka, MD, to discuss prosthesis–patient mismatch after transcatheter aortic valve replacement in patients with bicuspid aortic stenosis. Drawing from the Optimized Catheter Valvular Intervention–Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry, Dr. Yamanaka reports lower mismatch rates in bicuspid versus tricuspid anatomy, potentially due to larger annular dimensions. He also reflects on differences between findings from observational registries and recent clinical trials, emphasizing the importance of anatomy-driven, individualized approaches to valve selection.