What question did this study set out to answer?

The central aim is to compare left ventricular remodeling differences post-TAVR between bicuspid and tricuspid aortic valve patients with aortic stenosis.

January 10, 2026Open Access

Differences in Left Ventricular Remodeling Between Bicuspid Compared to Tricuspid Aortic Valve With Aortic Stenosis in a Chinese Population After Transcatheter Aortic Valve Replacement

Key Result

Patients with bicuspid aortic valve experienced less reverse left ventricular remodeling at one month post-TAVR compared to those with tricuspid valve (140.09 vs. 126.36 g/m², p = 0.044).

Key Points

The central aim is to compare left ventricular remodeling differences post-TAVR between bicuspid and tricuspid aortic valve patients with aortic stenosis.
Retrospective analysis of 137 patients with BAV and TAV undergoing TAVR from January 2019 to June 2022.
Echocardiographic follow-ups conducted at baseline and 6 months after TAVR.
Comparison of left ventricular remodeling and aortic root diameter between BAV and TAV patients.
BAV patients were younger and had a larger aortic root diameter than TAV patients.
BAV patients showed less reverse left ventricular remodeling one month after TAVR compared to TAV patients.
No significant differences in left ventricular mass index were noted at 24 hours or six months post-TAVR.

Structured PICO

Does TAVR in patients with bicuspid aortic valve result in different left ventricular reverse remodeling compared to tricuspid aortic valve in a Chinese population?

Population

101 Chinese patients with severe symptomatic aortic stenosis (intermediate-to-high surgical risk or STS >4), mean age 74.50, 47.52% male. Key inclusion: AVA ≤1.0 cm2, aortic valve index ≤0.6 cm2/m2, or peak aortic velocity (Vmax) ≥4.0 m/s.

Intervention

Transcatheter aortic valve replacement (TAVR) using a self-expandable valve in patients with bicuspid aortic valve (BAV) (n=42)

Comparator

Transcatheter aortic valve replacement (TAVR) using a self-expandable valve in patients with tricuspid aortic valve (TAV) (n=59)

Outcome

Differences in reverse left ventricular (LV) remodeling (specifically LV mass index [LVMi]) at 1-month and 6-month follow-up post-TAVRsurrogate

TAVR using a self-expandable valve in Chinese patients with bicuspid aortic valve yields similar mid-term left ventricular reverse remodeling compared to tricuspid aortic valve, despite slower initial remodeling at one month.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: The study aimed to compare the differences in reverse left ventricular (LV) remodeling following transcatheter aortic valve replacement (TAVR) between patients with the bicuspid aortic valve (BAV) and those with tricuspid aortic valve (TAV), both with aortic stenosis, in a Chinese population. Methods: A total of 137 patients were enrolled who were treated with a self-expandable Venus A valve at our center, who underwent TAVR from January 1, 2019, to June 30, 2022. We retrospectively included patients with BAV and TAV who underwent echocardiographic follow-ups at baseline and at least 6 months after the procedure. Results: Patients with a BAV were younger than those with a TAV. The BAV patients had a larger aortic root diameter (ARD), although the size of valve implantation was comparable between the two groups. Patients with a BAV might experience less reverse LV remodeling post-TAVR than patients with a TAV during the one-month follow-up (140.09 ± 36.94 g/m2 vs. 126.36 ± 26.96 g/m2; p = 0.044). There were no significant differences in the LV mass index (LVMi) between the two groups throughout the 24 hours or the six-month follow-up post-TAVR. Patients with a higher mean pressure gradient (MPG) (95% confidence interval (CI): 0.112–0.581; p = 0.004) and a larger ARD (95% CI: 0.519–5.573; p = 0.019) before TAVR had favorable mid-term LV reverse remodeling (ΔLVMi within 6 months) post-TAVR. Patients with much more severe aortic stenosis (AS) had favorable mid-term LV reverse remodeling post-TAVR. Conclusions: Patients with BAV might experience less reverse LV remodeling post-TAVR than patients with TAV during a short-term follow-up, but similar remodeling during mid-term follow-ups.

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