Transcatheter aortic valve replacement for stenotic bicuspid aortic valves: Systematic review and meta analyses of observational studies

Abstract

This analysis suggests that TAVR for BcAV is not associated with excess mortality. The incidence of paravalvular leaks and pacemaker implant is increased compared to tricuspid aortic valve cohorts undergoing TAVR, and operators should weigh these potential complications against the clinical benefit provided by TAVR for BcAV patients at high risk for surgical valve replacement.

Comparing outcomes after transcatheter aortic valve replacement in patients with stenotic bicuspid and tricuspid aortic valve: A systematic review and meta‐analysis

“…Other possible hypotheses include asymmetrical leaflet calcification and resistance to valve expansion . BAV is known to be associated with higher rates of pacemaker implantation in BAV cohorts compared with TAV cohorts . However, we found no difference in pacemaker implantation in the BAV group when directly compared with the TAV group from the same cohort.…”

“…BAV was believed to be more elliptical and would not fit well with prostheses, but a recent study has found that BAV is actually not more elliptical than TAV and should be able to fit commercially available prostheses . Other possible hypotheses include asymmetrical leaflet calcification and resistance to valve expansion . BAV is known to be associated with higher rates of pacemaker implantation in BAV cohorts compared with TAV cohorts .…”

Valvuloplasty balloon entrapment in a self‐expanding aortic valve stent frame after inadvertent wire passage through the outflow struts

“…Considering this with his other aforementioned comorbidities, we favored TAVR as a minimally invasive procedure. Regarding valve selection, a recent meta‐analyses by Reddy et al revealed no significant difference between self‐expanding and balloon‐expanding prostheses regarding acceptable device success rates and low early safety event rates. With the typical oval‐shaped bicuspid anatomy (Sievers I), we decided to work with a self‐expanding valve, which enables adequate sealing due to its conforming frame.…”

Subclinical leaflet thrombosis following transcatheter aortic valve replacement

“…TAVR in bicuspid aortic valve (BAV) has been associated with an increased incidence of paravalvular leak and need for pacemaker implantation . Overall, BAV anatomically is known to have larger SoVs than trileaflet aortic valve.…”