High AVG after an Aortic Valve Replacement

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TEEintraoppreopMEAVLAXCFD
Short case presentation
81 yo male, who weighed 83 kg and had a height of 168 cm, with history of a heart murmur. Preop TTE showed severe aortic stenosis with an AVA of 0.9 cm2. The patient underwent an AVR with a 21 mm Edwards pericardial valve. The IntraopPre AVR, IntraopPost AVR and the Postop TTE are shown below. Please review the IntraopPre AVR and IntraopPost AVR video loops and discuss the possible etiologies of the post AVR abnormality. What would you expect to find after an Edwards Pericardial valve that is 21 mm? What would be your recommendation to the surgeon after the AVR?