Review Article: Contemporary Transcatheter Heart Valves for TAVI in Bicuspid Aortic Anatomy
Chrysavgi Simopoulou, Omar Oliva, Vincenzo Cesario, Nicolas Dumonteil, Didier Tchetche, Chiara De Biase

TL;DR
This paper reviews the progress and current state of transcatheter heart valves for treating bicuspid aortic valve disease.
Contribution
The paper provides an updated review of contemporary transcatheter heart valves and their outcomes in bicuspid aortic anatomy.
Findings
Second- and third-generation THVs have improved TAVI outcomes in BAV patients.
Procedural success and hemodynamic performance are now comparable to tricuspid aortic valves.
Higher rates of PVL and strokes remain challenges in BAV TAVI.
Abstract
Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5–2% of the population and often leading to early aortic valve degeneration. While surgical aortic valve replacement (SAVR) remains the gold standard for treating severe bicuspid aortic stenosis (AS), transcatheter aortic valve implantation (TAVI) is emerging as a viable alternative in selected BAV anatomies. Initial experiences with first-generation transcatheter heart valves (THVs) showed the feasibility of this technique, but were associated with lower device success rates and higher complications, such as paravalvular leak (PVL) and pacemaker implantation. Advancements in second- and third- generation THVs, together with better pre-procedural imaging assessment and growing operator experience, have significantly enhanced TAVI outcomes in BAV patients, with results now comparable to those seen in…
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Taxonomy
TopicsCardiac Valve Diseases and Treatments · Aortic Disease and Treatment Approaches · Infective Endocarditis Diagnosis and Management
