Why the study?
Patients with bicuspid aortic valves were historically omitted from major TAVR trials despite bicuspid aortic stenosis not being unusual in clinical practice.
Does transcatheter aortic valve replacement provide a feasible and safe treatment option in patients with bicuspid aortic stenosis?
Does transcatheter aortic valve replacement provide a feasible and safe treatment option in patients with bicuspid aortic stenosis?
TAVR is a feasible and safe option for patients with bicuspid aortic stenosis, though it carries a higher risk of paravalvular regurgitation and permanent pacemaker implantation compared to tricuspid aortic stenosis.
TAVR feasibility in BAV remains hypothesis-generating; dedicated RCTs needed before expanding to low-risk patients.
In the last few years, transcatheter aortic valve replacement (TAVR) has rapidly become the standard of care for severe symptomatic aortic stenosis (AS). If initially it was preferred only for high-risk surgical patients, now even low-risk patients are eligible candidates. There were several factors to consider why patients with bicuspid aortic valves (BAVs) were omitted from these trials. However, it should be noted that bicuspid AS is not unusual among patients who experience transcatheter valve implantation. The TAVR procedure in BAV is a reliable and safe treatment option for surgical aortic valve replacement (SAVR) but it is associated with an elevated incidence of paravalvular regurgitation (PVR) and the likelihood of implanting a permanent pacemaker. Bicuspid valves do not appear to be a contraindication to TAVI according to current data, but further specific clinical trials will be required to confirm this conclusion.
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A 2023 study studied this question.
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