Premium
Early and midterm outcomes of transcatheter aortic valve replacement in patients with bicuspid aortic valves
Author(s) -
AalaeiAndabili Seyed Hossein,
Beaver Thomas M.,
Petersen John W.,
Anderson R David,
Karimi Ashkan,
Thoburn Eric,
Kabir Ali,
Bavry Anthony A.,
Arnaoutakis George J.
Publication year - 2018
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.13775
Subject(s) - medicine , bicuspid aortic valve , cardiology , valve replacement , aortic valve replacement , aortic valve , stenosis
Background Bicuspid aortic valve (BAV) stenosis has been considered a relative contraindication to transcatheter aortic valve replacement (TAVR). We compared the outcomes of TAVR in patients with BAV stenosis versus patients with trileaflet aortic valve stenosis. Methods From March 2012 to September 2017, 727 patients underwent TAVR. Thirty‐two patients with BAV were included in this study and compared to 96 patients with comparable risk factors (1:3) with a trileaflet aortic valve (TAV). Transesophageal echocardiography was used to estimate post‐TAVR degree of paravalvular leak (PVL). Results Mean ± standard deviation Society of Thoracic Surgeons risk was 6.01 ± 3.42 in the BAV group and 6.08 ± 3.76 in the TAV group ( P = 0.92). Thirty‐day mortality was 4.2% ( N = 4) in the TAV group and 6.25% ( N = 2) in the BAV group ( P = 0.63). Three (3.1%) patients in the TAV group and two (6.25%) patients in the BAV group developed a post operative stroke ( P = 0.59). Following TAVR, mean aortic valve gradient significantly decreased in both TAV (42.56 ± 14.93 vs 9.27 ± 5.57, P < 0.001) and BAV (44.12 ± 11.82 vs 9.03 ± 7.29, P < 0.001) groups. No patient had a severe PVL after TAVR, and only two (2.08%) patients in the TAV group and one (3.12%) patient in the BAV group had moderate PVL ( P = 1.0). Patient survival rate at 1 and 2 years was 86% in the BAV group and 90% at 1 and 2 years in the TAV group ( P = 0.74). Conclusions TAVR in BAV disease is feasible with favorable valve performance. Immediate and mid‐term outcomes of TAVR in patients with BAV are comparable to those with TAV.