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  • Comparison of One- and 12-M...
    Comparison of One- and 12-Month Outcomes of Transcatheter Aortic Valve Replacement in Patients With Severely Stenotic Bicuspid Versus Tricuspid Aortic Valves (Results from a Multicenter Registry)
    Kochman, Janusz, MD, PhD; Huczek, Zenon, MD, PhD; Ścisło, Piotr, MD, PhD; Dabrowski, Maciej, MD, PhD; Chmielak, Zbigniew, MD, PhD; Szymański, Piotr, MD, PhD; Witkowski, Adam, MD, PhD; Parma, Radosław, MD, PhD; Ochala, Andrzej, MD, PhD; Chodór, Piotr, MD, PhD; Wilczek, Krzysztof, MD, PhD; Reczuch, Krzysztof W., MD, PhD; Kubler, Piotr, MD, PhD; Rymuza, Bartosz, MD; Kołtowski, Łukasz, MD, PhD; Ścibisz, Anna, MD, PhD; Wilimski, Radosław, MD, PhD; Grube, Eberhard, MD, PhD; Opolski, Grzegorz, MD, PhD

    The American journal of cardiology, 09/2014, Volume: 114, Issue: 5
    Journal Article

    The aim of the study was to evaluate the transcatheter aortic valve replacement (TAVR) in high-risk patients with severe bicuspid aortic valve (BAV) stenosis and to compare the outcomes with a matched group of patients with tricuspid aortic valve. TAVR became an alternative treatment method in high-risk patients with symptomatic aortic stenosis; however, BAV stenosis is regarded as a relative contraindication to TAVR. The study population comprised 28 patients with BAV who underwent TAVR. BAV was diagnosed based on a transesophageal echocardiography. CoreValve and Edwards SAPIEN prostheses were implanted. The control group consisted of 84 patients (3:1 matching) with significant tricuspid aortic valve stenosis treated with TAVR. There were no significant differences between patients with and without BAV in device success (93% vs 93%, p = 1.0), risk of annulus rupture (0% in both groups), or conversion to cardiosurgery (4% vs 0%, respectively, p = 0.25). The postprocedural mean pressure gradient (11.5 ± 6.4 vs 10.4 ± 4.5 mm Hg, p = 0.33), aortic regurgitation grade ≥2 of 4 (32% vs 23%, p = 0.45), 30-day mortality (4% vs 7%, p = 0.68), and 1-year all-cause mortality (19% vs 18%, p = 1.00) did not differ between the groups. Echocardiography showed well-functioning valve prosthesis with a mean prosthetic valve area of 1.6 ± 0.4 cm2 versus 1.7 ± 0.3 cm2 (p = 0.73), a mean pressure gradient of 10.3 ± 5.4 versus 9.8 ± 2.8 mm Hg (p = 0.64), and aortic regurgitation grade ≥2 of 4 (22% vs 22%, p = 1.00) for the 2 groups. In conclusion, selected high-risk patients with BAV can be successfully treated with TAVR, and their outcomes are similar to those reported in patients without BAV.

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