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Contemporary management of severe symptomatic bicuspid aortic valve stenosis: the BiTri Registry

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  1. Threshold for calcium volume evaluation in patients with aortic valve stenosis: correlation with Agatston score

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  2. Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

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  1. Patient-Specific Implantation Technique to Obtain Neo-Commissural Alignment With Self-Expanding Transcatheter Aortic Valves

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  2. Technical Considerations for Transcatheter Aortic Valve Replacement With the Navitor Transcatheter Heart Valve

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  3. First-in-human results of the OMEGA™ Left Atrial Appendage Occluder for Patients with Non-Valvular Atrial Fibrillation

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  4. Impact of early hospital discharge on clinical outcomes after transcatheter aortic valve implantation

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  • Chiara De Biase
  • Saif Siddiqui
  • Bruno Brochado
  • Francesca Ziviello
  • Nicolas M van Mieghem
  • Ole De Backer
  • Lars Sondergaard
  • João Silveira
  • Christophe Saint-Etienne
  • Thierry Bourguignon
  • Rudiger Lange
  • Marija Jovanovic
  • Pierre Berthoumieu
  • Sabine Bleiziffer
  • Andrea Tuccillo
  • Caroline Lemee
  • Kevin Chapdelaine
  • Nicolas Dumonteil
  • Didier Tchetche
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AIMS: A greater number of patients with bicuspid aortic valves (BAV) may be identified and treated as indications for transcatheter aortic valve implantation (TAVI) are expected to expand to younger patients. We evaluated the contemporary frequency and management of symptomatic patients with stenotic BAV in a multicenter European registry.

METHODS: Between November 2017 and February 2018, all consecutive patients admitted for symptomatic aortic stenosis across six high-volume European hospitals were prospectively enrolled in the BiTri registry.

RESULTS: Of the 832 patients, 17% (n = 138) had a BAV. The most frequent BAV phenotypes were type 1 (left--right coronary cusps fusion 64%) and type 1 (right-noncoronary cusps fusion 17%). Type 0 and type 2 accounted for 12 and 2%, respectively. When compared with tricuspid patients (n = 694), BAV patients were younger, with lower surgical risk. The transthoracic echocardiography (TTE) identified BAV in 64% of patients. Multisliced computed tomography (MSCT) additionally completed the diagnosis in 20% of patients. Surgical inspection finally identified the remaining undiagnosed 16% of BAV. A combination of TTE and MSCT was the most common diagnosis method for BAV. Surgical aortic valve replacement (SAVR) was the predominant therapeutic option for BAV (70%) whilst TAVI was performed in 26%.

CONCLUSION: BAV is frequently observed in symptomatic patients with aortic stenosis. These patients are younger, have a lower risk profile and are predominantly treated with SAVR as compared with tricuspid patients. However, TAVI is performed in almost one-third of BAV patients in contemporary European practice. TTE combined with MSCT identified 84% of BAV.

Original languageEnglish
JournalJournal of Cardiovascular Medicine
Volume22
Issue number6
Pages (from-to)492-495
Number of pages4
ISSN1558-2027
DOIs
Publication statusPublished - 1 Jun 2021

    Research areas

  • bicuspid aortic valve, multislice-computed tomography, transcatheter aortic valve implantation, transcatheter heart valves

ID: 62239548