Transcatheter aortic valve replacement in bicuspid aortic valve stenosis

被引:8
作者
Yoon, Sung-Han [1 ]
Webb, John G. [2 ]
Leon, Martin B. [3 ]
Makkar, Raj [1 ]
机构
[1] Cedars Sinai Med Ctr, Inst Heart, Los Angeles, CA 90048 USA
[2] Univ British Columbia, Ctr Heart Valve Innovat, Vancouver, BC, Canada
[3] Columbia Univ, Med Ctr, New York, NY USA
关键词
Aortic stenosis; Transcatheter aortic valve implantation; Bicuspid aortic valve; OUTCOMES; FREQUENCY;
D O I
10.1016/j.pcad.2020.06.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality in adults, and symptoms typically develops in adulthood. In the majority of cases, BAV disease progresses with age and surgical aortic valve replacement (AVR) is performed with excellent operative outcomes. Based on a series of randomized trials, transcatheter AVR (TAVR) has evolved from a novel technology to an established therapy for patients with symptomatic severe aortic stenosis (AS) regardless of risk profile. Despite exclusion of bicuspid anatomy from the randomized trials, an increasing number of patients with BAV-AS have been treated with TAVR. Recent observational studies showed the comparable outcomes of TAVR between bicuspid and tricuspid AS. However, worse outcomes in patients with unfavorable bicuspid anatomy such as calcified raphe plus excessive leaflet calcification have raised concerns for TAVR in younger and lower risk population. For the further expansion of TAVR toward BAV-AS population, we need randomized trials of TAVR in this population. Until then, previous registry data combined with computed tomographic-based anatomical assessment may guide the optimal therapy in patients with bicuspid anatomy. (c) 2020 Published by Elsevier Inc.
引用
收藏
页码:482 / 487
页数:6
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