eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
1/2021
vol. 17
 
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abstract:
Original paper

Comparison of the results of transcatheter aortic valve implantation in patients with bicuspid and tricuspid aortic valve

Piotr A. Chodór
1
,
Krzysztof Wilczek
2
,
Karolina Chodór-Rozwadowska
3
,
Roman Przybylski
4
,
Jan Głowacki
5
,
Tomasz Niklewski
6
,
Łukasz Włoch
1
,
Mariusz Gąsior
2
,
Marian Zembala
6
,
Zbigniew Kalarus
1

  1. Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
  2. 3rd Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
  3. Doctoral School, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Disease, Zabrze, Poland
  4. Department of Heart Diseases, Clinic of Cardiac Transplantation and Mechanical Circulatory Support, Wroclaw Medical University, Wroclaw, Poland
  5. Department of Radiology, Medical University of Silesia, Diagnostic Department, Silesian Center for Heart Diseases, Zabrze, Poland
  6. Department of Cardiac Surgery and Transplantology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
Adv Interv Cardiol 2021; 17, 1 (63): 82–92
Online publish date: 2021/03/27
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Introduction
Indications for transcatheter aortic valve implantation (TAVI) are constantly expanding, including younger patients. Bicuspid aortic valves (BAV) often occur in this group. In order to achieve optimal treatment results in younger patients, it is necessary to develop an effective method for selecting the size of implanted valves. Aim: To compare the results of TAVI with use of a self-expanding prosthesis in patients with a BAV and a tricuspid aortic valve (TAV) with valve selection based on annular sizing.

Material and methods
The diagnosis of BAV and TAV and measurements (annular sizing) were based on multi-slice computed tomography scans. Eighty-three patients received a self-expanding CoreValve or Evolut R prosthesis. In group I (BAV) there were 21 (25.3%) patients and in group II (TAV) there were 62 (74.7%) patients.

Results
The groups did not differ in terms of baseline clinical characteristics. Device success was achieved in 16 (76.2%) and 55 (88.7%) (p = NS) in group I and II respectively. Composite endpoints: early safety occurred in 5 (23.8%) and 11 (17.7%) patients (p =NS) in group I and II respectively; clinical efficacy occurred in 10 (47.6%) and 28 (45.2%) patients (p = NS) in group I and II respectively. 30-day mortality was 4.8% vs 9.7%, 1-year mortality was 28.6% vs 17.7% (p = NS) in group I and II respectively.

Conclusions
TAVI in patients with severe aortic stenosis and BAV is as effective as in patients with TAV using self-expanding prostheses if the valve selection is based on annular sizing.

keywords:

transcatheter aortic valve implantation, bicuspid aortic valve, multi-slice computed tomography

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