Transcatheter Aortic Valve Replacement in Bicuspid vs. Tricuspid Aortic Stenosis

TAVR results in bicuspid AS are encouraging, but caution is still warranted.

As transcatheter aortic valve replacement (TAVR) continues to expand to lower-risk and younger patients with aortic stenosis (AS), more patients with bicuspid AS are being considered despite being excluded from randomized trials. In this international observational registry of patients undergoing TAVR, 546 patients with mostly (86%) Sievers type 1 bicuspid valves were compared to a propensity-matched cohort of patients with tricuspid valves. Mean age at baseline was 77 years; 62% were male; mean STS risk was 4.5%. Transfemoral access was used in 86% of patients with a variety of devices, distributed similarly between cohorts.

Procedural mortality was similar in the bicuspid and tricuspid groups (1.3% vs. 1.1%); however, conversion to surgery…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)