1. CharActeristics, sizing anD outcomes of stenotic, tapered, rapHe-type bicuspid aOrtic valves treated with trans-catheter device implantation: Insights the AD HOC registry.
- Author
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Buono A, De Biase C, Fabris T, Bellamoli M, Kim WK, Montarello N, Costa G, Zito A, Alfadhel M, Koren O, Fezzi S, Bellini B, Massussi M, Scotti A, Bai L, Costa G, Mazzapicchi A, Giacomin E, Gorla R, Latini A, Fraccaro C, Sondergaard L, Strazzieri O, Boiago M, Busco M, Charitos E, Orbach A, Messina A, Bettari L, Navazio E, Paglianiti DA, Nagasaka T, Napodano M, Villa E, Angelillis M, Ielasi A, Landes U, Brambilla N, Bedogni F, Mangieri A, Saia F, Favero L, Chen M, Adamo M, Latib A, Petronio AS, Montorfano M, Makkar RR, Mylotte D, Blackman DJ, Barbanti M, De Backer O, Tchètchè D, Maffeo D, and Tarantini G
- Abstract
Background: Raphe-type bicuspid aortic valve (BAV) is a potential hostile scenario in trans-catheter aortic valve replacement (TAVR) due to pronounced calcium burden, possibly associated with tapered valve configuration. Trans-Catheter heart valve (THV) sizing strategy (annular vs. supra-annular) is controversial in this valve subtype., Objectives: To describe the phenotypical characteristics of severe, tapered, raphe-type, BAV stenosis undergoing TAVR and to explore safety and efficacy of modern-generation THVs, analysing the impact of annular and supra-annular sizing strategies on short- and mid-terms outcomes., Methods: This is a retrospective, multicenter registry enrolling consecutive stenotic Sievers type 1 BAV treated with TAVR. Study population was divided into tapered and non-tapered configuration according to MSCT analysis. Matched comparison between annular and supra-annular sizing groups was performed in tapered population., Results: From January 2016 to June 2023, 897 patients were enrolled. Of them, 696 patients displayed a tapered configuration. Of those, 510 received a THV according to annular sizing. After propensity score matching 186 matched pairs were selected. Technical success (96.2 % vs 94.1 %, OR 1.61 [0.61-4.24], p = 0.34), 30-day device success (83.6 % in both groups, OR 1.42 [0.78-2.57], p = 0.25) and 30-day early safety (71.8 % vs 70.5 %, OR 1.07 [0.68-1.68], p = 0.78) were similar between the annular and supra-annular sizing groups; a higher post-TAVR gradient was observed in supra-annular group, although it was only 2 mmHg mean. At mid-term follow-up, the rate of clinical efficacy was 84.7 %., Conclusions: TAVR with modern-generation devices is safe and effective for tapered raphe-type BAV, showing comparable results for annular and supra-annular sizing strategies., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)
- Published
- 2024
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