Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Stenosis

Flavien Vincent, MD, PhD; Julien Ternacle, MD, PhD*; Tom Denimal, MD; Mylène Shen, MSc; Bjorn Redfors, MD, PhD; Cédric Delhaye, MD; Matheus Simonato, MD; Nicolas Debry, MD; Basile Verdier, MD; Bahira Shahim, MD, PhD; Thibault Pamart, MD; Hugues Spillemaeker, MD; Guillaume Schurtz, MD; François Pontana, MD, PhD; Vinod H. Thourani, MD; Philippe Pibarot, DVM, PhD; Eric Van Belle, MD, PhD


Circulation. 2021;143(10):1043-1061. 

In This Article

What are the Results of Surgery?

The outcomes of surgery are excellent in BAV patients, with very low hospital mortality ranging from 0.9% to 2.4%;[22,23] however, studies have mainly reported outcomes in young patients at very low operative risk treated with biological or mechanical valves for different types of AV diseases, and with or without concomitant aortic intervention.[23–27]

Contrary to TAVR, long-term data are available for SAVR. Borger and David reported an excellent 88% survival rate at 10 years in a series of 231 patients with an average age of 52 years and treated by AVR with concomitant ascending aorta replacement.[22] Other studies reported a 15-year survival rate ranging between 40% and 78% after SAVR with or without aortic replacement.[23,28–30] However, there is a paucity of data on the outcomes of SAVR in BAV patients at increased surgical risk. Elbadawi et al reported a 44.6% bleeding rate, 27.2% blood transfusion, and 3.1% in-hospital death[25] after SAVR in a cohort of patients matched with high-risk TAVR. Overall, SAVR is a well-known and standardized procedure that provides excellent procedural and long-term results in young BAV patients with few comorbidities.