TY - JOUR
T1 - Comparison of results of transcatheter aortic valve implantation in patients with severely stenotic bicuspid versus tricuspid or nonbicuspid valves
AU - Costopoulos, Charis
AU - Latib, Azeem
AU - Maisano, Francesco
AU - Testa, Luca
AU - Bedogni, Francesco
AU - Buchanan, Louise
AU - Naganuma, Toru
AU - Sticchi, Alessandro
AU - Sato, Katsumasa
AU - Miyazaki, Tadashi
AU - Figini, Filippo
AU - Giannini, Francesco
AU - Taramasso, Maurizio
AU - Naim, Charbel
AU - Carlino, Mauro
AU - Chieffo, Alaide
AU - Montorfano, Matteo
AU - Alfieri, Ottavio
AU - Colombo, Antonio
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/4/15
Y1 - 2014/4/15
N2 - Data on transcatheter aortic valve implantation (TAVI) for severe bicuspid aortic valve (BAV) stenosis and how this compares to that for tricuspid aortic valve (TAV) stenosis are limited. Twenty-one consecutive patients with BAV were treated with the Edwards or CoreValve bioprosthesis from November 2007 to December 2012 at San Raffaele Scientific Institute and Clinical Institute S. Ambrogio, Milan, Italy. Results were compared with a cohort of patients with TAV (n = 447) treated with the same bioprostheses over the same period. Procedural 1- and 12-month outcomes were examined as defined by the Valve Academic Research Consortium criteria. Patients with BAV were younger (76.7 ± 7.1 vs 79.8 ± 7.4 years, p = 0.06) and with a larger aortic annulus (25.0 ± 1.8 vs 23.6 ± 2.1 mm, p = 0.01). Device success (85.7% vs 94.4%, p = 0.10) was lower in patients with BAV. Although the 30-day composite safety end point (23.8% vs 21.0%, p = 0.76) was similar between the 2 groups, mortality rate at 30 days was higher (14.2% vs 3.6%, p = 0.02) in the BAV group. Cardiovascular mortality at 1 year did not differ significantly between the 2 groups (10.5% vs 7.4%, p = 0.62). In conclusion, transcatheter aortic valve implantation in high surgical risk patients with severe BAV stenosis appears to be feasible with mid-term cardiovascular mortality similar to that for patients with TAV. Early survival and device success, however, were lower for patients with BAV demonstrating that further studies are required to identify which subset of patients with BAV is best suited for transcatheter treatment.
AB - Data on transcatheter aortic valve implantation (TAVI) for severe bicuspid aortic valve (BAV) stenosis and how this compares to that for tricuspid aortic valve (TAV) stenosis are limited. Twenty-one consecutive patients with BAV were treated with the Edwards or CoreValve bioprosthesis from November 2007 to December 2012 at San Raffaele Scientific Institute and Clinical Institute S. Ambrogio, Milan, Italy. Results were compared with a cohort of patients with TAV (n = 447) treated with the same bioprostheses over the same period. Procedural 1- and 12-month outcomes were examined as defined by the Valve Academic Research Consortium criteria. Patients with BAV were younger (76.7 ± 7.1 vs 79.8 ± 7.4 years, p = 0.06) and with a larger aortic annulus (25.0 ± 1.8 vs 23.6 ± 2.1 mm, p = 0.01). Device success (85.7% vs 94.4%, p = 0.10) was lower in patients with BAV. Although the 30-day composite safety end point (23.8% vs 21.0%, p = 0.76) was similar between the 2 groups, mortality rate at 30 days was higher (14.2% vs 3.6%, p = 0.02) in the BAV group. Cardiovascular mortality at 1 year did not differ significantly between the 2 groups (10.5% vs 7.4%, p = 0.62). In conclusion, transcatheter aortic valve implantation in high surgical risk patients with severe BAV stenosis appears to be feasible with mid-term cardiovascular mortality similar to that for patients with TAV. Early survival and device success, however, were lower for patients with BAV demonstrating that further studies are required to identify which subset of patients with BAV is best suited for transcatheter treatment.
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U2 - 10.1016/j.amjcard.2014.01.412
DO - 10.1016/j.amjcard.2014.01.412
M3 - Article
C2 - 24581922
AN - SCOPUS:84897459594
SN - 0002-9149
VL - 113
SP - 1390
EP - 1393
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -