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. 2024 Sep 13;10:e11. doi: 10.15420/cfr.2023.23

Table 3: Studies of Bicuspid Patients.

Author Patients (n) Population Major Findings
Forrest et al. 2020[6] 150 patients Low-risk bicuspid
  • TAVR with self-expanding valves had a high device success with low rate of death or disabling stroke at 30 days

Waksman et al. 2020[17] 61 bicuspid TAVR Low-risk patients undergoing TAVR with self-expanding or balloon expandable valves
  • At 30 days, there was zero mortality and no disabling strokes

  • Permanent pacemaker implantation 13.1% and moderate paravalvular leak 1.6% at 30 days

  • Hypo-attenuated leaflet thickening (10% at 30 days) was not associated with clinical events

Halim et al. 2020[18] 5,412 bicuspid TAVR procedures Low-risk TAVR
  • When current-generation devices were used in bicuspid TAVR, device success increased (93.5% versus 96.3%; p=0.001) and the incidence of 2+ aortic insufficiency declined (14.0% versus 2.7%; p<0.001) in comparison with older-generation devices

  • The adjusted 1-year mortality was lower (HR 0.88; 95% CI [0.78–0.99]) in bicuspid TAVR compared with tricuspid TAVR, but no difference in the 1-year stroke risk was observed (HR 1.14; 95% CI [0.94–1.39])

Forrest et al. 2020[19] 932 bicuspid TAVR, 26,154 tricuspid TAVR Low-risk patients undergoing TAVR with self-expanding valves from TVT registry
  • After propensity matching, all-cause mortality at 30 days (2.6% versus 1.7%; p=0.18) and 1 year (10.4% versus 12.1%; p=0.63), as well the rate of stroke at 30 days (3.4% versus 2.7%; p=0.41) and 1 year (3.9% versus 4.4%; p=0.93), were comparable between bicuspid and tricuspid TAVR

TAVR = transcatheter aortic valve replacement; TVT = transcatheter valve therapy.