title: Transcatheter aortic valve implantation in bicuspid anatomy.
abstract: Transcatheter aortic valve implantation (TAVI) is an established therapeutic option for high-risk patients with tricuspid aortic valve stenosis. Historically, the presence of a bicuspid aortic valve (BAV) has been regarded as a contraindication to TAVI, on the basis of putative concerns about the associated risks of elliptical deployment, accelerated leaflet degeneration, periprosthetic leaks, and aortic complications. Fortunately, with technological refinements and mounting experience, reasonable success has been achieved with TAVI in selected patients with a BAV. The rate of procedural success is high, and survival is similar to that in patients with a tricuspid aortic valve who undergo TAVI. Nevertheless, moderate or severe aortic regurgitation and aortic dissection seem to occur more frequently in patients with a BAV rather than a tricuspid aortic valve. Specifically-designed prospective studies should address these concerns and help to define anatomical selection criteria before TAVI can be recommended for patients with a BAV.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Road, 610041 Chengdu, China.
authors.forename: Zhen-Gang
authors.initials: ZG
authors.lastname: Zhao
authors.affiliation: Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A3600, Los Angeles, CA 90048, USA.
authors.forename: Hasan
authors.initials: H
authors.lastname: Jilaihawi
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Road, 610041 Chengdu, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Road, 610041 Chengdu, China.
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D000784:Aortic Dissection / Q000209:etiology; D001014:Aortic Aneurysm / Q000209:etiology; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D000075202:Contraindications; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000379:methods*