Sep. 2, 2013 — Bicuspid aortic valve (BV) is the most common congenital valvular abnormality, occurring in 1-2% of the general population. Two of the aortic valvular leaflets fuse during development resulting in a valve that is bicuspid instead of the normal tricuspid configuration. BV is associated with increased mechanical stress which predisposes to calcification and development of aortic stenosis which narrows the opening of the aortic valve.
Dr Bauer said: "TAVI is used to treat elderly high risk patients with severe aortic stenosis. Despite previous assumptions the frequency of BV is quite high even among elderly patients with symptomatic aortic stenosis."
But he added: "BV has been considered a relative contraindication to TAVI. One of the main reasons is the presumed risk for relevant aortic regurgitation, where blood leaks back through the aortic valve during ventricular diastole. However, case reports and small case series have suggested that TAVI can be successfully performed with acceptable clinical outcomes in high risk patients with BV."
The study prospectively enrolled 1,424 patients with severe aortic stenosis undergoing TAVI into the German TAVI-Registry between January 2009 and June 2010. For the present analysis patients with valve-in-valve procedures were excluded and those with BV (n=38, 2.7%) were compared to those with tricuspid aortic valve (TV) (n=1,357, 97.3%). Patient characteristics did not markedly differ and procedural success was very high in both groups.
The researchers found a higher rate of relevant aortic regurgitation (
Dr Bauer said: "TAVI is used to treat elderly high risk patients with severe aortic stenosis. Despite previous assumptions the frequency of BV is quite high even among elderly patients with symptomatic aortic stenosis."
But he added: "BV has been considered a relative contraindication to TAVI. One of the main reasons is the presumed risk for relevant aortic regurgitation, where blood leaks back through the aortic valve during ventricular diastole. However, case reports and small case series have suggested that TAVI can be successfully performed with acceptable clinical outcomes in high risk patients with BV."
The study prospectively enrolled 1,424 patients with severe aortic stenosis undergoing TAVI into the German TAVI-Registry between January 2009 and June 2010. For the present analysis patients with valve-in-valve procedures were excluded and those with BV (n=38, 2.7%) were compared to those with tricuspid aortic valve (TV) (n=1,357, 97.3%). Patient characteristics did not markedly differ and procedural success was very high in both groups.
The researchers found a higher rate of relevant aortic regurgitation (