Why the study?
Does transcatheter aortic valve replacement (TAVR) provide a safe and efficacious alternative to surgical aortic valve replacement (SAVR) in patients with bicuspid aortic valve and severe symptomatic aortic stenosis?
Does transcatheter aortic valve replacement (TAVR) provide a safe and efficacious alternative to surgical aortic valve replacement (SAVR) in patients with bicuspid aortic valve and severe symptomatic aortic stenosis?
TAVR appears to be a safe and efficacious alternative to SAVR in patients with bicuspid aortic valves, though randomized trials are needed to definitively establish its utility and address risks of paravalvular regurgitation and pacemaker implantation.
May guide TAVR decisions in select bicuspid cases; leaves open need for randomized trials to confirm safety.
Transcatheter aortic valve replacement (TAVR) for the treatment of severe symptomatic aortic stenosis (AS) has rapidly become the standard of care for expanding clinical indications based on the results of multiple large-scale randomized trials. Patients with bicuspid aortic valve (BAV) have been largely excluded from these trials for a variety of reasons. However, case series and registry data has shown TAVR in BAV to be a safe and efficacious alternative to surgical aortic valve replacement (SAVR) with the possible caveats of increased paravalvular regurgitation (PVR) and need for permanent pacemaker (PPM) implantation. Randomized trials are needed to determine the ultimate utility of TAVR in patients with BAV.
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Patel et al. (2018) studied this question.
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