News | AP VALVES & SH 2024
TAVR for Bicuspid AV: What's Different?
Live Case & Lecture 2: Bicuspid, Mitral TEER
Jung-Min Ahn
Asan Medical Center, Republic of Korea
At the AP VALVES & STRUCTURAL HEART 2024 conference, Professor Jung-Min Ahn from Asan Medical Center delivered important findings on the challenges and outcomes of Transcatheter Aortic Valve Replacement (TAVR) in bicuspid aortic valve (BAV) patients. Despite the anatomical complexities of BAV, the data from Asan Medical Center suggest that TAVR can be performed as safely and effectively as in tricuspid aortic valve (TAV) patients, albeit with some unique procedural considerations.
Between 2016 and 2023, Asan Medical Center conducted TAVR on approximately 1,000 patients using the Sapien 3 valve system, with 124 of these patients having BAV (Figure 1). They found that BAV patients were generally younger (mean age 77), predominantly male, and had fewer comorbidities compared to those with TAV. Echocardiographic findings indicated more severe aortic valve stenosis in BAV patients, with higher transaortic pressure gradients and more significant calcification, as evidenced by higher calcium volumes (Figure 2).
Figure 1
Figure 2
Procedurally, BAV cases required larger transcatheter heart valves (THVs) and more frequent pre- and post-dilation. Notably, in BAV patients with heavy calcification, the strategy leaned toward less valve oversizing to reduce procedural risks (Figure 3). While the rates of pacemaker implantation and paravalvular leak were slightly higher in BAV patients, these differences were not statistically significant. Long-term outcomes showed no significant differences in mortality or stroke rates between BAV and TAV patients up to two years after the procedure (Figure 4, 5).
Figure 3
Figure 4
Figure 5
Professor Ahn emphasized the need for developing specific criteria, similar to the Echo-Score used in rheumatic mitral stenosis, to better identify BAV patients who are ideal candidates for TAVR. This could further enhance procedural success and patient outcomes in this complex patient group.
Live Case & Lecture 2: Bicuspid, Mitral TEER
Thursday, August 08, 2:30 PM ~ 4:10 PM
Main Arena, Vista Hall 1, B2
Edited by
Hoyun Kim, MD
Sejong Hospital, Korea (Republic of)
Jung-Min Ahn
Asan Medical Center, Republic of Korea
At the AP VALVES & STRUCTURAL HEART 2024 conference, Professor Jung-Min Ahn from Asan Medical Center delivered important findings on the challenges and outcomes of Transcatheter Aortic Valve Replacement (TAVR) in bicuspid aortic valve (BAV) patients. Despite the anatomical complexities of BAV, the data from Asan Medical Center suggest that TAVR can be performed as safely and effectively as in tricuspid aortic valve (TAV) patients, albeit with some unique procedural considerations.
Between 2016 and 2023, Asan Medical Center conducted TAVR on approximately 1,000 patients using the Sapien 3 valve system, with 124 of these patients having BAV (Figure 1). They found that BAV patients were generally younger (mean age 77), predominantly male, and had fewer comorbidities compared to those with TAV. Echocardiographic findings indicated more severe aortic valve stenosis in BAV patients, with higher transaortic pressure gradients and more significant calcification, as evidenced by higher calcium volumes (Figure 2).
Procedurally, BAV cases required larger transcatheter heart valves (THVs) and more frequent pre- and post-dilation. Notably, in BAV patients with heavy calcification, the strategy leaned toward less valve oversizing to reduce procedural risks (Figure 3). While the rates of pacemaker implantation and paravalvular leak were slightly higher in BAV patients, these differences were not statistically significant. Long-term outcomes showed no significant differences in mortality or stroke rates between BAV and TAV patients up to two years after the procedure (Figure 4, 5).
Professor Ahn emphasized the need for developing specific criteria, similar to the Echo-Score used in rheumatic mitral stenosis, to better identify BAV patients who are ideal candidates for TAVR. This could further enhance procedural success and patient outcomes in this complex patient group.
Live Case & Lecture 2: Bicuspid, Mitral TEER
Thursday, August 08, 2:30 PM ~ 4:10 PM
Main Arena, Vista Hall 1, B2
Edited by
Hoyun Kim, MD
Sejong Hospital, Korea (Republic of)
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