ACC 2019 | TAVR in Bicuspids is Safe and Feasible in Real World Patients

Experts still won’t agree on whether to carry out randomized trial to put an end to this discussion, but it seems clear that balloon expandable TAVR is valid only for certain anatomies.  

ACC 2019 | TAVI en bicúspides es seguro y factible en pacientes seleccionados del mundo realTAVR in real world bicuspid valve populations is associated with similar outcomes at 30 days and one year when compared against cohorts with regular valves, according to the new registry.

 

However, patients with bicuspid anatomy have higher risk of root rupture, conversion to conventional surgery, and stroke.

 

Data have given grounds for TAVR to be considered a reasonable alternative for patients at high or intermediate risk of surgery, which calls for a randomized study.


Read also: ACC 2019 | PARTNER 3: Low Risk TAVR vs. Surgery, Fewer Events per Year.


This registry shows that patients with bicuspid anatomy required more conversion to surgery (0.9% vs 0.4%; p=0.03) and presented more annulus rupture (0.3% vs 0; p=0.02). Numerically, yet not significantly, a second valve was needed for bicuspid patients.

 

At 30 days, there were no differences in all-cause mortality, life threatening bleeding, vascular complications or reinterventions in both groups. The difference lies on a higher stroke rate in the bicuspid cohort (2.4% vs 1.6%; p=0.02) and the need for pacemaker implantation (9.1% vs 7.5%; p=0.03). Most strokes were periprocedural.

 

At one year, these differences disappeared both in mortality and in stroke, and also in the combination of both events.


Read also: ACC 2019 | TAVR in Low-Risk Patients Is Noninferior.


Paravalvular leak tended to be higher in bicuspid patients (p=0.08) but resulted equivalent at 30 days and one year, compared with the tricuspid cohort.  

 

Original title: Outcomes of transcatheter aortic valve replacement with balloon-expandable Sapien 3 valve in bicuspid aortic stenosis: an analysis of the STS/ACC TVT registry.

Presenter: Makkar RR.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | Asymptomatic Severe Aortic Stenosis: What Should Be our Approach?

Approximately 3% of the population over 65 years old has aortic stenosis. Current guidelines recommend valve replacement for patients with symptoms or an ejection...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | Asymptomatic Severe Aortic Stenosis: What Should Be our Approach?

Approximately 3% of the population over 65 years old has aortic stenosis. Current guidelines recommend valve replacement for patients with symptoms or an ejection...

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...