Fogelson et al. should be commended on constructing a very well written manuscript, which appears in this issue of Cardiovascular Revascularization Medicine , regarding their single-center experience in the management of the entire spectrum of patients with severe symptomatic aortic valve stenosis (SSAS) who were deemed to be appropriate candidates for transcatheter aortic valve implantation (TAVI) [ ]. It is particularly commendable that the authors as an initial thesis deemed it important to further investigate whether there is a difference in the access to care for patients with SSAS depending on their geography. This topic has not been uniformly embraced as a topic that needs to be further investigated, yet we believe that their efforts are timely and will help all readers become more self-reflective regarding how geography can impact patients' cardiovascular care. Their findings can extend beyond the management of patients with aortic valve stenosis and can have a significant impact on how we each manage patients in our various practice environments.