Mid‐term outcome in patients with bicuspid aortic valve stenosis following transcatheter aortic valve replacement with a current generation device: A multicenter study

Objectives To perform clinical and echocardiographic follow‐up beyond 1 year in consecutive patients with severe bicuspid aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) with a current generation balloon‐expandable valve. Background Treatment of bicuspid aortic valve disease with TAVR remains controversial and late follow‐up data is still scarce. Methods We collected baseline characteristics, procedural data, 30‐day and mid‐term clinical follow‐up findings from six centers in Europe and Canada from patients with bicuspid AS treated with TAVR using the SAPIEN 3 valve. Results Seventy‐nine patients underwent TAVR. Mean age was 76 ± 9 years; median STS risk score for mortality was 3.8% (interquartile range 2.3–5.5%). Median follow‐up was 390 days (interquartile range 138–739 days). Device success was achieved in 95% of patients. Postimplantation mean aortic gradient decreased from 50.2 ± 16.2 to 8.8 ± 4.4 mmHg and no patient had more than mild aortic regurgitation. At last follow‐up, there was persistent good valve performance. At 30 days and 1 year, the rates of all‐cause mortality were 3.8 and 7.7%, stroke 1.2 and 1.2%, and the rate of new pacemakers 18 and 18%. Conclusions Our data confirm that treating patients with stenotic bicuspid aortic valves is safe, effective, and has favorable valve performance over time.