Transcatheter Aortic Valve Implantation for Bicuspid Aortic Valve Disease: Procedural Planning and Clinical Outcomes.
Lola GutierrezMauro BoiagoChiara De BiaseOmar OlivaPietro LaforgiaSouheib FeliachiAlessandro BeneduceNicolas DumonteilDidier TchetchePublished in: Journal of clinical medicine (2023)
Bicuspid aortic valve (BAV) is the most common congenital heart disease, with a prevalence of 1-2% and occurring in >20% of octogenarians referred for aortic valve replacement. However, BAV patients have been systematically excluded from pivotal randomized trials. Since TAVI indications are moving toward low-risk patients, an increase in the number of BAV patients who undergo TAVI is expected. BAV represents a challenge due to its unique morphological features (raphe, extreme asymmetrical valve calcifications, cusp asymmetry and aortopathy) and the lack of consensus about the accurate sizing method. The role of multi-slice computed tomography (MSCT) in the planification of the TAVI procedure is well-established, being useful to define the optimal valve sizing and the implantation strategy. New-generation devices, more experience of the operators and better planification of the procedure have been associated with similar clinical outcomes in bicuspid and tricuspid patients undergoing TAVI.
Keyphrases
- aortic valve
- transcatheter aortic valve implantation
- aortic stenosis
- aortic valve replacement
- ejection fraction
- transcatheter aortic valve replacement
- computed tomography
- congenital heart disease
- patients undergoing
- newly diagnosed
- end stage renal disease
- chronic kidney disease
- coronary artery disease
- high resolution
- risk factors
- magnetic resonance
- heart failure
- clinical practice
- positron emission tomography
- pet ct