Mid-term outcome in patients with bicuspid aortic valve stenosis following transcatheter aortic valve replacement with a current generation device: A multicenter study

Adrian Attinger-Toller, Rahul Bhindi, Gidon Y. Perlman, Dale Murdoch, Jonathan Weir-McCall, Philipp Blanke, Marco Barbanti, Janarthanan Sathananthan, Philipp Ruile, Caterina Gandolfo, Francesco Saia, Fabian Nietlispach, David Wood, Jonathon Leipsic, John G. Webb

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To perform clinical and echocardiographic follow-up beyond 1 year in consecutive patients with severe bicuspid aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) with a current generation balloon-expandable valve. Background: Treatment of bicuspid aortic valve disease with TAVR remains controversial and late follow-up data is still scarce. Methods: We collected baseline characteristics, procedural data, 30-day and mid-term clinical follow-up findings from six centers in Europe and Canada from patients with bicuspid AS treated with TAVR using the SAPIEN 3 valve. Results: Seventy-nine patients underwent TAVR. Mean age was 76 ± 9 years; median STS risk score for mortality was 3.8% (interquartile range 2.3–5.5%). Median follow-up was 390 days (interquartile range 138–739 days). Device success was achieved in 95% of patients. Postimplantation mean aortic gradient decreased from 50.2 ± 16.2 to 8.8 ± 4.4 mmHg and no patient had more than mild aortic regurgitation. At last follow-up, there was persistent good valve performance. At 30 days and 1 year, the rates of all-cause mortality were 3.8 and 7.7%, stroke 1.2 and 1.2%, and the rate of new pacemakers 18 and 18%. Conclusions: Our data confirm that treating patients with stenotic bicuspid aortic valves is safe, effective, and has favorable valve performance over time.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - Jan 1 2019

Keywords

  • aortic valve disease percutaneous intervention
  • paravalvular leak
  • structural heart disease intervention
  • transcatheter valve implantation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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