But I'd love to learn from you, Grant, how do you approach in general and maybe for this patient TAVR versus SAVR in patients with bicuspid aortic stenosis?

Eduard, I'm glad that I, I trained you guys well because those are a lot of the points that I would make.

One, one key point that I think we should at all appreciate as interventionalists and as cardiologists in general is that when we think about the lifetime management of a patient with aortic valve disease, we should be thinking about a strategy in which we can minimize the number of sternotomies in the patient's life.

And if they do need surgery, which many patients with bicuspid aortic valve disease do, it's performing surgery at an age that the surgery will be the lowest risk possible.

And in some patients that may have, for instance, radiation heart disease or a compelling reason to avoid surgery at a young age, TAVR as a first strategy may make sense.

But I think it should always be approached from the mindset of how do we best strategize for not just now, but five and ten years and, and even twenty years down the road.

Um, and with bicuspid aortic valve, the majority of bicuspid valve TAVR, I think the vast majority that I'm doing, are in patients who are, who are actually high surgical risk, who are patients who have bicuspid anatomy, which either are younger and as in this patient, have reduced ejection fraction or end-stage renal disease or some compelling reason to avoid surgery, but yet have bicuspid anatomy.

Do you, do you find that the pre-BAV has the same value utility in Severts zero non-raphe type bicuspid valves?