Bicuspid aortic valve disease, with a global incidence of 1.3%, presents unique therapeutic challenges, though TAVI has emerged as a viable alternative to traditional surgery in selected patients.
This review summarizes the pathophysiology and treatment of bicuspid aortic valve disease, highlighting TAVI as an emerging viable alternative to traditional surgery in selected patients.
The Bicuspid Aortic Valve (BAV) is the most common congenital anomaly in adults, with a global incidence of 1.3%. Despite being well documented, BAV presents significant clinical challenges due to its phenotypic heterogeneity, diverse clinical manifestations, and variable outcomes. Pathophysiologically, BAV differs from tricuspid valves in calcification patterns and hemodynamic effects, leading to increased shear stress and aortic root dilatation, while it is influenced by genetic and hemodynamic factors. This is why therapeutically, BAV presents challenges for both surgical and transcatheter interventions, with surgical approaches being traditionally preferred, especially when aortopathy is present. However, transcatheter aortic valve implantation (TAVI) has emerged as a viable option, with studies showing comparable outcomes to surgery in selected patients, while advancements in TAVI and a better understanding of BAV's genetic and pathophysiological nuances are expanding treatment options. The choice between mechanical and bioprosthetic valves also presents considerations, particularly regarding long-term durability and the need for anticoagulation. Future research should focus on long-term registries and genetic studies to refine therapeutic strategies and improve patient outcomes. This review aims to evaluate current approaches in the surgical and interventional management of BAV, focusing on its anatomy, pathogenesis, pathophysiology, and therapeutic strategies.
Katsaros et al. (Fri,) conducted a review in Bicuspid Aortic Valve Disease. Surgical and transcatheter interventions was evaluated. Bicuspid aortic valve disease, with a global incidence of 1.3%, presents unique therapeutic challenges, though TAVI has emerged as a viable alternative to traditional surgery in selected patients.
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