Key result
Urgent TAVR rapidly stabilizes hemodynamics in a patient with severe BAV stenosis and cardiogenic shock.
Why the study?
Treatment of severe aortic stenosis in cardiogenic shock remains challenging, particularly in younger patients with bicuspid valve stenosis.
Does urgent transcatheter aortic valve replacement improve hemodynamic stability in a patient with severe bicuspid aortic valve stenosis and cardiogenic shock?
Case Report (n=1)
Does urgent transcatheter aortic valve replacement improve hemodynamic stability in a patient with severe bicuspid aortic valve stenosis and cardiogenic shock?
Urgent TAVR may be a viable and effective treatment strategy for patients with severe bicuspid aortic valve stenosis presenting in refractory cardiogenic shock.
Answers are grounded in this paper and cite their sources.
May support urgent TAVR feasibility in bicuspid AS shock; hypothesis-generating case report requiring prospective validation.
BACKGROUND: Treatment of severe aortic stenosis in cardiogenic shock remains challenging, particularly in younger patients with bicuspid valve stenosis (BVS). CASE SUMMARY: A 51-year-old woman with severe high-gradient BVS presented in cardiogenic shock with multiorgan dysfunction. Given hemodynamic instability, the heart team proceeded with urgent transcatheter aortic valve replacement. A 26-mm balloon-expandable Edwards SAPIEN 3 Ultra RESILIA valve was successfully implanted, resulting in rapid hemodynamic stabilization. DISCUSSION: This case highlights the importance of urgent heart team decision-making in unstable patients with severe BVS. Lifetime management requires individualized device selection considering annular dimensions, calcification pattern, coronary access, and future redo-procedure strategies. TAKE-HOME MESSAGES: In the presence of refractory cardiogenic shock, transcatheter aortic valve replacement may be the preferred treatment strategy and should be considered as part of an individualized lifetime management strategy.
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Jurisic et al. (2026) conducted a case report in Severe bicuspid aortic valve stenosis with cardiogenic shock (n=1). Urgent transcatheter aortic valve replacement was evaluated on Hemodynamic stabilization. Urgent transcatheter aortic valve replacement resulted in rapid hemodynamic stabilization in a 51-year-old woman with severe bicuspid aortic valve stenosis and cardiogenic shock.
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