Bicuspid Aortic Valve Morphology and Outcomes After Transcatheter Aortic Valve Replacement

Yoon, Sung‐Han; Kim, Won-Keun; Dhoble, Abhijeet; Pio, Stephan Milhorini; Babaliaros, Vasilis; Jilaihawi, Hasan; Pilgrim, Thomas; Backer, Ole De; Bleiziffer, Sabine; Vincent, Flavien; Shmidt, Tobias; Butter, Christian; Kamioka, Norihiko; Eschenbach, Lena Katharina; Renker, Matthias; Asami, Masahiko; Lazkani, Mohamad; Fujita, Buntaro; Birs, Antoinette; Barbanti, Marco; Pershad, Ashish; Landes, Uri; Oldemeyer, Brad; Kitamura, M; Oakley, Luke; Ochiai, Tomoki; Chakravarty, Tarun; Nakamura, Mamoo; Ruile, Philip; Deuschl, Florian; Berman, Daniel S.; Modine, Thomas; Ensminger, Stephan; Kornowski, Ran; Lange, Rüdiger; McCabe, James M.; Williams, Mathew; Whisenant, Brian; Delgado, Victoria; Windecker, Stephan; Belle, Éric Van; Søndergaard, Lars; Chevalier, Bernard; Mack, Michael J.; Bax, Jeroen J.; Leon, Martin B.; Makkar, Raj

doi:10.1016/j.jacc.2020.07.005

Cited by 148 publications

(79 citation statements)

References 31 publications

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“…A recent study reported on 929 propensity matched pairs (bicuspid versus tricuspid) with self-expandable TAVR devices; the researchers found no difference in 30-day or 1-year all-cause death or stroke; however, patients with a bicuspid valve undergoing TAVR were more likely to require aortic valve reintervention at both 30 days and 1 year compared to patients with tricuspid valve undergoing TAVR [127]. Finally, the Bicuspid AS TAVR Registry, which included 1,034 patients with analyses of CCT images [128] showed that patients with a calcified raphe or excess leaflet calcification had increased early mortality and higher rates of periprocedural complications including aortic root injury and moderate or severe PVL (Fig. 24).…”

Section: Interventional Cardiology Considerationsmentioning

confidence: 99%

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

Michelena

Corte²,

Evangelista³

et al. 2021

Radiology: Cardiothoracic Imaging

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This International Consensus Classification and Nomenclature for the congenital bicuspid aortic valve condition recognizes 3 types of bicuspid valves: 1. The fused type (right-left cusp fusion, right-non-coronary cusp fusion and left-non-coronary cusp fusion phenotypes); 2. The 2-sinus type (latero-lateral and antero-posterior phenotypes); and 3. The partial-fusion (forme fruste) type. The presence of raphe and the symmetry of the fused type phenotypes are critical aspects to describe. The International Consensus also recognizes 3 types of bicuspid valve-associated aortopathy: 1. The ascending phenotype; 2. The root phenotype; and 3. Extended phenotypes.

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Section: Interventional Cardiology Considerationsmentioning

confidence: 99%

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

Michelena

Corte²,

Evangelista³

et al. 2021

Radiology: Cardiothoracic Imaging

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“…The most important lesson from those trials is that the surgical risk may affect the perioperative and mid-term survival of sAVR as well as the mid-term survival of TAVR patients but not the perioperative survival of the latter. The anatomical risk on the degree and distribution of calcification as well as the presence of a bicuspid valve or left ventricular outflow tract (LVOT) calcifications has been associated with inferior results in TAVR 34 – 36 . This knowledge became more evident during the evolution of TAVR and patients with high anatomical risk conditions have been excluded from randomization.…”

Section: Discussionmentioning

confidence: 99%

Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis

Khalil

Ignatiuk

Erdem

et al. 2021

Sci Rep

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Transcatheter aortic valve replacement (TAVR) has shown to reduce mortality compared to surgical aortic valve replacement (sAVR). However, it is unknown which procedure is associated with better post-procedural valvular function. We conducted a meta-analysis of randomized clinical trials that compared TAVR to sAVR for at least 2 years. The primary outcome was post-procedural patient-prosthesis-mismatch (PPM). Secondary outcomes were post-procedural and 2-year: effective orifice area (EOA), paravalvular gradient (PVG) and moderate/severe paravalvular leak (PVL). We identified 6 trials with a total of 7022 participants with severe aortic stenosis. TAVR was associated with 37% (95% CI [0.51–0.78) mean RR reduction of post-procedural PPM, a decrease that was not affected by the surgical risk at inclusion, neither by the transcatheter heart valve system. Postprocedural changes in gradient and EOA were also in favor of TAVR as there was a pooled mean difference decrease of 0.56 (95% CI [0.73–0.38]) in gradient and an increase of 0.47 (95% CI [0.38–0.56]) in EOA. Additionally, self-expandable valves were associated with a higher decrease in gradient than balloon ones (beta = 0.38; 95% CI [0.12–0.64]). However, TAVR was associated with a higher risk of moderate/severe PVL (pooled RR: 9.54, 95% CI [5.53–16.46]). All results were sustainable at 2 years.

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“…However, AR commonly co-exists with aortic dilatation, necessitating evaluation of the thoracic aorta by thoracic CT. Most recent cardiac CT research in the field of AV disease focusses on the question whether specific anatomical features, such as bicuspid AV and calcification severity, predict outcome (mortality, iatrogenic AR, …) after TAVR [38][39][40][41]. take home message on the utility of Cmr in ar severity grading:…”

Section: A B New Imaging Modalities To Assess Aortic Regurgitationmentioning

confidence: 99%

Comprehensive assessment of the aortic valve in critically ill patients for the non-cardiologist. Part II: Chronic aortic regurgitation of the native valve

Walpot¹,

Vermeiren²,

Mafragi³

et al. 2021

ait

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Aortic regurgitation (AR) is caused by incomplete diastolic closure of the aortic valve (AV). Diastolic regurgitation towards the left ventricle (LV) causes LV volume overload, resulting in eccentric LV remodelling.The Framingham Study has reported a prevalence of traceable AR by echocardiography of 13.0% in men and 8.5% in women in the study population [1], with moderate and severe AR occurring in 0.5% of the total study population [2].This review intends to give a comprehensive overview of the assessment of AR for clinicians work-

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Bicuspid Aortic Valve Morphology and Outcomes After Transcatheter Aortic Valve Replacement

Cited by 148 publications

References 31 publications

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis

Comprehensive assessment of the aortic valve in critically ill patients for the non-cardiologist. Part II: Chronic aortic regurgitation of the native valve

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