Hemodynamic and Conduction System Outcomes in Sievers Type 0 and Sievers Type 1 Bicuspid Aortic Valves Post Transcatheter Aortic Valve Replacement

Kumar, Kris; Simpson, Timothy F.; Akhavein, Reyhaneh; Rajotte, Katherine; Weller, S.D.V.; Fuss, Cristina; Song, Howard K.; Golwala, Harsh; Zahr, Firas; Chadderdon, Scott

doi:10.1080/24748706.2021.1883782

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…The route of access was reported in 18 studies, and 91.8% of procedures were transfemoral. The most common devices used were the CoreValve (Medtronic, Minneapolis, Minnesota, USA) and Evolut R (Medtronic) ( 15 , 18 , 25 - 27 , 29 , 30 , 32 - 41 ), used in 17 studies, and the SAPIEN 3 (Edwards Lifesciences, Irvine, California, USA) and SAPIEN XT valves (Edwards Lifesciences), used in 13 studies ( 15 , 26 , 30 , 32 - 40 , 42 ). The Lotus EDGE (Boston Scientific, Marlborough, Massachusetts, USA) was used in six studies ( 15 , 25 , 26 , 28 , 33 , 35 ) and the VenusA-valve (Venus MedTech, Hangzhou, China) was used in four studies from Mainland China ( 18 , 24 , 31 , 33 ).…”

Section: Resultsmentioning

confidence: 99%

“…The current study found that BAV patients undergoing TAVR had a 30-day and one-year overall mortality of 2.1% and 9.6% respectively. Included studies that reported the highest 30-day mortality were from 2010 to 2014, while studies that reported the lowest 30-day mortality were from 2020 to 2021 ( 15 , 24 , 27 , 38 , 41 , 42 ). This trend was also seen in one-year mortality results, where the three studies that reported the highest one-year mortality were from 2010 to 2014, while the three studies with the lowest one-year mortality were from 202 to 2021 ( 26 , 27 , 30 , 38 , 39 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

“…Included studies that reported the highest 30-day mortality were from 2010 to 2014, while studies that reported the lowest 30-day mortality were from 2020 to 2021 ( 15 , 24 , 27 , 38 , 41 , 42 ). This trend was also seen in one-year mortality results, where the three studies that reported the highest one-year mortality were from 2010 to 2014, while the three studies with the lowest one-year mortality were from 202 to 2021 ( 26 , 27 , 30 , 38 , 39 , 42 ). This may suggest an improved safety profile of TAVR in BAV patients, as centers are increasingly incorporating TAVR as an alternative or even preferred treatment for BAV stenosis.…”

Section: Discussionmentioning

confidence: 99%

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Procedural and clinical outcomes of transcatheter aortic valve replacement in bicuspid aortic valve patients: a systematic review and meta-analysis

Chen¹,

Jiang²,

Martin³

et al. 2022

Ann Cardiothorac Surg

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Background: Currently, bicuspid aortic valve (BAV) anatomy remains a relative contraindication for transcatheter aortic valve replacement (TAVR) due to concerns of suboptimal anatomy. However, recent advancements in the field have provided a wealth of promising data and more clinicians are opting for TAVR as an alternative to surgical repair. We aim to review and analyze the available data for TAVR in BAV patients, targeting procedural outcomes, clinical outcomes and mortality with up to two years of follow-up.Methods: A literature search of five databases was performed and all primary studies published between 2002 and 2021 that reported procedural, clinical or mortality outcome data were identified. Following data extraction, a meta-analysis of means or proportions was performed using a random effects model. Heterogeneity was assessed using the I 2 statistic.Results: A total of 22 studies with 1,945 BAV patients were identified. The mean age was 74.1 years and 58.8% of patients were male. Device success rates was 87.5%. Moderate to severe paravalvular leak (PVL) was seen in 3.7% of procedures. Clinical outcomes included new permanent pacemaker insertion (PPI) (11.8%), major bleeding (3.5%), major vascular complications (2.5%), stroke (2.3%), acute kidney injury (2.1%) and coronary obstruction (0.1%). Mortality in hospital, at 30-days, one and two years of follow-up were 1.9%, 2.1%, 9.6% and 12.9%, respectively.Conclusions: This assessment of the available data on TAVR for BAV shows promising outcomes and low rates of complications. However, further research is warranted to reduce the heterogeneity of the available data and provide insight into outcomes beyond two years of follow-up.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Procedural and clinical outcomes of transcatheter aortic valve replacement in bicuspid aortic valve patients: a systematic review and meta-analysis

Chen¹,

Jiang²,

Martin³

et al. 2022

Ann Cardiothorac Surg

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Patient-Specific Computer Simulation to Optimize Transcatheter Heart Valve Sizing and Positioning in Bicuspid Aortic Valve

et al. 2021

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Patients with a Bicuspid Aortic Valve (BAV) Diagnosed with ECG-Gated Cardiac Multislice Computed Tomography—Analysis of the Reasons for Referral, Classification of Morphological Phenotypes, Co-Occurring Cardiovascular Abnormalities, and Coronary Artery Stenosis

Machowiec,

Przybylski,

Czekajska-Chehab

et al. 2024

JCM

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Background/Objectives: The aim of this study was to analyze a group of patients with a bicuspid aortic valve (BAV) examined with ECG-gated cardiac CT (ECG-CT), focusing on the assessment of the clinical reasons for cardiac CT, cardiovascular abnormalities coexisting with their BAV, and coronary artery stenosis. Methods: A detailed statistical analysis was conducted on 700 patients with a BAV from a group of 15,670 patients examined with ECG-CT. Results: The incidence of a BAV in ECG-CT was 4.6%. The most common reason for examination was suspicion of coronary heart disease—31.1%. Cardiovascular defects most frequently associated with a BAV were a VSD (4.3%) and coarctation of the aorta (3.6%), while among coronary anomalies, they were high-take-off coronary arteries (6.4%) and paracommissural orifice of coronary arteries (4.4%). The analysis of the coronary artery calcium index showed significantly lower values for type 2 BAV compared to other valve types (p < 0.001), with the lowest average age in this group of patients. Moreover, the presence of a raphe between the coronary and non-coronary cusps was associated with a higher rate of significant coronary stenosis compared to other types of BAVs (p < 0.001). Conclusions: The most common reason for referral for cardiac ECG-CT in the group ≤ 40-year-olds with a BAV was the suspicion of congenital cardiovascular defects, while in the group of over 40-year-olds, it was the suspicion of coronary artery disease. The incidence of cardiovascular abnormalities co-occurring with BAV and diagnosed with ECG-CT differs among specific patient subgroups. The presence of a raphe between the coronary and non-coronary cusps appears to be a potential risk factor for significant coronary stenosis in patients with BAVs.

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Hemodynamic and Conduction System Outcomes in Sievers Type 0 and Sievers Type 1 Bicuspid Aortic Valves Post Transcatheter Aortic Valve Replacement

Cited by 3 publications

References 27 publications

Procedural and clinical outcomes of transcatheter aortic valve replacement in bicuspid aortic valve patients: a systematic review and meta-analysis

Procedural and clinical outcomes of transcatheter aortic valve replacement in bicuspid aortic valve patients: a systematic review and meta-analysis

Patient-Specific Computer Simulation to Optimize Transcatheter Heart Valve Sizing and Positioning in Bicuspid Aortic Valve

Patients with a Bicuspid Aortic Valve (BAV) Diagnosed with ECG-Gated Cardiac Multislice Computed Tomography—Analysis of the Reasons for Referral, Classification of Morphological Phenotypes, Co-Occurring Cardiovascular Abnormalities, and Coronary Artery Stenosis

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