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Transcatheter aortic valve implantation in bicuspid anatomy

Nature Reviews Cardiology volume 12, pages 123–128 (2015)Cite this article

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Abstract

Transcatheter aortic valve implantation (TAVI) is an established therapeutic option for high-risk patients with tricuspid aortic valve stenosis. Historically, the presence of a bicuspid aortic valve (BAV) has been regarded as a contraindication to TAVI, on the basis of putative concerns about the associated risks of elliptical deployment, accelerated leaflet degeneration, periprosthetic leaks, and aortic complications. Fortunately, with technological refinements and mounting experience, reasonable success has been achieved with TAVI in selected patients with a BAV. The rate of procedural success is high, and survival is similar to that in patients with a tricuspid aortic valve who undergo TAVI. Nevertheless, moderate or severe aortic regurgitation and aortic dissection seem to occur more frequently in patients with a BAV rather than a tricuspid aortic valve. Specifically-designed prospective studies should address these concerns and help to define anatomical selection criteria before TAVI can be recommended for patients with a BAV.

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Figure 1: Frequency of BAV in TAVI and AVR cohorts.
Figure 2: CoreValve® (Medtronic CV Luxembourg S.a.r.l., Luxembourg) structure and geometry in BAVs.

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Author information

Authors and Affiliations

  1. Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, China

    Zhen-Gang Zhao, Yuan Feng & Mao Chen

  2. Cedars–Sinai Heart Institute, Cedars–Sinai Medical Center, 127 South San Vicente Boulevard, Suite A3600, Los Angeles, 90048, CA, USA

    Hasan Jilaihawi

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Z.-G.Z. and H.J. researched the data for the article and wrote the manuscript. All the authors contributed substantially to the discussion of content, and reviewed/edited the manuscript before submission.

Corresponding author

Correspondence to Mao Chen.

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Competing interests

H.J. declares that he is a consultant for Edwards Lifesciences, St. Jude Medical, and Venus MedTech. The other authors declare no competing interests.

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Zhao, ZG., Jilaihawi, H., Feng, Y. et al. Transcatheter aortic valve implantation in bicuspid anatomy. Nat Rev Cardiol 12, 123–128 (2015). https://doi.org/10.1038/nrcardio.2014.161

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