Transcatheter aortic valve replacement in bicuspid aortic valve stenosis. 2020

Sung-Han Yoon, and John G Webb, and Martin B Leon, and Raj Makkar
Cedars-Sinai Medical Center, Heart Institute, Los Angeles, CA, United States of America.

Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality in adults, and symptoms typically develops in adulthood. In the majority of cases, BAV disease progresses with age and surgical aortic valve replacement (AVR) is performed with excellent operative outcomes. Based on a series of randomized trials, transcatheter AVR (TAVR) has evolved from a novel technology to an established therapy for patients with symptomatic severe aortic stenosis (AS) regardless of risk profile. Despite exclusion of bicuspid anatomy from the randomized trials, an increasing number of patients with BAV-AS have been treated with TAVR. Recent observational studies showed the comparable outcomes of TAVR between bicuspid and tricuspid AS. However, worse outcomes in patients with unfavorable bicuspid anatomy such as calcified raphe plus excessive leaflet calcification have raised concerns for TAVR in younger and lower risk population. For the further expansion of TAVR toward BAV-AS population, we need randomized trials of TAVR in this population. Until then, previous registry data combined with computed tomographic-based anatomical assessment may guide the optimal therapy in patients with bicuspid anatomy.

UI MeSH Term Description Entries
D006349 Heart Valve Diseases Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE). Heart Valvular Disease,Valvular Heart Diseases,Disease, Heart Valvular,Heart Disease, Valvular,Heart Valve Disease,Heart Valvular Diseases,Valve Disease, Heart,Valvular Disease, Heart,Valvular Heart Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000082882 Bicuspid Aortic Valve Disease Congenital heart valve defects where the AORTIC VALVE has two instead of normal three cusps. It is often associated with AORTIC REGURGITATION and AORTIC INSUFFICIENCY. Bicuspid Aortic Valve, Single Raphe,Bicuspid Aortic Valve, Two-Raphe,Double Raphe Bicuspid Aortic Valve,Purely Bicuspid Aortic Valve,Single Raphe Bicuspid Aortic Valve,Two Raphe Bicuspid Aortic Valve,Two-Raphe Bicuspid Aortic Valve,Aortic Valve Disease 1,Aortic Valve, Bicuspid,Bicuspid Aortic Valve,Bicuspid Aortic Valve, Two Raphe,Bicuspid Aortic Valves,Valve, Bicuspid Aortic
D001021 Aortic Valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Aortic Valves,Valve, Aortic,Valves, Aortic
D001024 Aortic Valve Stenosis A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA. Aortic Stenosis,Aortic Valve Stenoses,Stenoses, Aortic,Stenoses, Aortic Valve,Stenosis, Aortic,Stenosis, Aortic Valve,Valve Stenoses, Aortic,Valve Stenosis, Aortic
D065467 Transcatheter Aortic Valve Replacement Surgical treatment for severe AORTIC VALVE STENOSIS. Transcatheter aortic valve replacement (TAVR) is used as an alternative option in patients who are deemed at high risk or inoperable for traditional open-heart surgery. Transcatheter Aortic Valve Implantation

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