Outcomes of transcatheter aortic valve replacement for bicuspid aortic stenosis – a systematic review of existing literature

ABSTRACT

Introduction: Patients with bicuspid aortic valve (BAV) have traditionally been excluded from large randomized clinical trials involving transcatheter aortic valve replacements (TAVR). Technical enhancements, availability of new generation devices and improved outcomes have led to a marked increase in TAVR volume across the world including off label use in patients with BAV stenosis.

Areas covered: In this manuscript, we have reviewed the currently available data regarding safety, efficacy, and outcomes of TAVR in patients with BAV stenosis. 11 large observational studies with near 1300 patients with BAV stenosis were included to summarizes outcomes of TAVR.

Expert Commentary: The present review suggested that TAVR may be a safe and feasible treatment modality in BAV stenosis patients. New generation devices were associated with high device success rate whereas higher adverse procedural events were observed in early generation devices. There are no differences in post procedural outcomes with new generation TAVR devices for BAV when compared to tricuspid aortic anatomy. Larger studies are needed to evaluate the long-term outcome and durability of TAVR in patients with BAV.

KEYWORDS:

• Bicuspid aortic valve
• transcatheter aortic valve replacement
• aortic stenosis
• systematic review
• outcomes and procedural complications

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper is not funded.