Demonstrates the feasibility of TAVR in a high-risk patient with bicuspid aortic stenosis, a population traditionally disqualified from this procedure.
Supports TAVR feasibility in select bicuspid AS cases; leaves open validation in prospective trials.
Although transcatheter aortic valve replacement (TAVR) has been accepted as an attractive alternative for high-risk patients with severe symptomatic aortic stenosis (AS), patients with congenital bicuspid AS has been typically disqualified for this indication due to an implied risk of device dislocation, distortion, or device malfunctioning. Nonetheless, bicuspid AS is not uncommon and frequently missed by transthoracic echocardiography. We reported an interesting case of a high-risk patient with severe symptomatic bicuspid AS who underwent successful TAVR and discussed the anatomic requirements for a safe implant in patients with bicuspid AS considered candidates for TAVR.
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Maluenda et al. (2013) studied this question.
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