TY - JOUR

T1 - Transcatheter aortic valve implantation in patients with bicuspid valve morphology

T2 - a roadmap towards standardization

AU - Xiong, Tian Yuan

AU - Ali, Walid Ben

AU - Feng, Yuan

AU - Hayashida, Kentaro

AU - Jilaihawi, Hasan

AU - Latib, Azeem

AU - Lee, Michael Kang Yin

AU - Leon, Martin B.

AU - Makkar, Raj R.

AU - Modine, Thomas

AU - Naber, Christoph

AU - Peng, Yong

AU - Piazza, Nicolo

AU - Reardon, Michael J.

AU - Redwood, Simon

AU - Seth, Ashok

AU - Sondergaard, Lars

AU - Tay, Edgar

AU - Tchetche, Didier

AU - Yin, Wei Hsian

AU - Chen, Mao

AU - Prendergast, Bernard

AU - Mylotte, Darren

N1 - Publisher Copyright: © 2022, Springer Nature Limited.

PY - 2023

Y1 - 2023

N2 - Indications for transcatheter aortic valve implantation (TAVI) have expanded in many countries to include patients with aortic stenosis who are at low surgical risk, and a similar expansion to this cohort is anticipated elsewhere in the world, together with an increase in the proportion of patients with bicuspid aortic valve (BAV) morphology as the age of the patients being treated decreases. To date, patients with BAV have been excluded from major randomized trials of TAVI owing to anatomical considerations. As a consequence, BAV has been a relative contraindication to the use of TAVI in international guidelines. Although clinical experience and observational data are accumulating, BAV presents numerous anatomical challenges for successful TAVI, despite advances in device design. Furthermore, in those with BAV, substantial geographical variation exists in patient characteristics, clinical approach and procedural strategy. Therefore, in this Roadmap article, we summarize the existing evidence and provide consensus recommendations from an international group of experts on the application of TAVI in patients with BAV in advance of the anticipated growth in the use of this procedure in this challenging cohort of patients.

AB - Indications for transcatheter aortic valve implantation (TAVI) have expanded in many countries to include patients with aortic stenosis who are at low surgical risk, and a similar expansion to this cohort is anticipated elsewhere in the world, together with an increase in the proportion of patients with bicuspid aortic valve (BAV) morphology as the age of the patients being treated decreases. To date, patients with BAV have been excluded from major randomized trials of TAVI owing to anatomical considerations. As a consequence, BAV has been a relative contraindication to the use of TAVI in international guidelines. Although clinical experience and observational data are accumulating, BAV presents numerous anatomical challenges for successful TAVI, despite advances in device design. Furthermore, in those with BAV, substantial geographical variation exists in patient characteristics, clinical approach and procedural strategy. Therefore, in this Roadmap article, we summarize the existing evidence and provide consensus recommendations from an international group of experts on the application of TAVI in patients with BAV in advance of the anticipated growth in the use of this procedure in this challenging cohort of patients.

UR - http://www.scopus.com/inward/record.url?scp=85132161088&partnerID=8YFLogxK

U2 - 10.1038/s41569-022-00734-5

DO - 10.1038/s41569-022-00734-5

M3 - Journal article

C2 - 35726019

AN - SCOPUS:85132161088

VL - 20

SP - 52

EP - 67

JO - Nature Reviews Cardiology

JF - Nature Reviews Cardiology

SN - 1759-5002

IS - 1

ER -