Evolution of Bicuspid Valves at 12 Months

Severe aortic stenosis due to a bicuspid aortic valve (BAV) is uncommon, especially in individuals under 65 years of age. While there are usually no significant differences according to the type of valve when it comes to surgery, with transcatheter aortic valve replacement (TAVR) some may arise. 

válvulas bicúspides

TAVR has seen significant advancements in the treatment of this disease. In some registries, its progression resembles that of tricuspid aortic valves (TAV). However, whether the different types of BAV have a similar evolution remains uncertain.

Researchers conducted an analysis on 1319 consecutive patients who underwent TAVR, of which 642 had TAV, 328 had BAV Type 0, and 302 had BAV Type I. 

The primary endpoint (PE) assessed was all-cause death and stroke at 30 days and one year.

Given the differences between the populations, propensity score matching was applied, resulting in 121 patients in each group. 

The average age was 73 years; 62% of patients were men, the STS score was 5.1%, 19% of subjects had diabetes, 45% of patients had chronic obstructive pulmonary disease (COPD), 34% had coronary artery disease, 18% had a history of stroke, and 15% had atrial fibrillation.

Read also: Use of IVUS in Complex PCI: Results according to Operator Experience.

In most cases, self-expanding valves were implanted. Hospital complications were similar between the groups. 

There were no significant differences in the PE between the groups (6% vs. 2% vs. 2% for BAV Type 0, Type I, and TAV).

The 30-day mortality rates were 4.2% vs. 1.7% vs. 1.7%, respectively, and the 1-year mortality rates were 10% vs. 2.3% vs. 6.2%. The incidence of stroke was 1% vs. 0.9% vs. 0% at 30 days and 1.4% vs. 1.6% vs. 1.3% at one year.

Read also: Retrograde Approach to Chronic Total Occlusions: Techniques and Outcomes According to the PROGRESS-CTO Registry.

The presence of a mean gradient ≥20 mmHg was more frequent in the BAV Type 0 group.

Conclusion

Major clinical events after TAVR in aortic stenosis patients with bicuspid aortic valve Type 0, Type I, and tricuspid aortic valve were equivalent in the short and medium term during follow-up. These observations suggest the need for future research in international prospective registries or randomized studies.

Dr. Carlos Fava - Consejo Editorial SOLACI

Dr. Carlos Fava.
Member of the Editorial Board of SOLACI.org.

Original Title: Outcomes Following Transcatheter Aortic Valve Replacement for Aortic Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid Aortic Valves.

Reference: Jingjing He, et al. Circ Cardiovasc Interv. 2023;16:e013083. DOI: 10.1161/CIRCINTERVENTIONS.123.013083.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....