Transcatheter aortic valve replacement (TAVR) is a new therapeutic option to treat patients with symptomatic severe aortic stenosis, and a prohibitive mortality risk for conventional surgical AVR2. A thorough understanding of the procedural steps involved in TAVR is imperative for all components of the heart time. Balloon aortic valvuloplasty under rapid ventricular pacing is one of the main procedural steps, and is usually performed before valve insertion to enable passage of the prosthesis through the stenotic native aortic valve. Hemodynamic collapse necessitating prompt intervention may occur at different stages during the procedure.