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Review
. 2022 Aug 4:16:e21.
doi: 10.15420/usc.2021.32. eCollection 2022.

Bicuspid Aortic Stenosis with and without Aortopathy: Considerations for Surgical Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement

Arthur J Lee  1 , Imran Baig  1 , Katherine B Harrington  1 , Molly Szerlip  1
Affiliations
Review

Bicuspid Aortic Stenosis with and without Aortopathy: Considerations for Surgical Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement

Arthur J Lee et al. US Cardiol. .

Abstract

The treatment of aortic stenosis has evolved in recent years with the introduction of transcatheter aortic valve replacement (TAVR) as a complementary strategy to surgical aortic valve replacement (SAVR). The majority of clinical trials to date have included only tricuspid aortic stenosis and excluded bicuspid aortic valves (BAVs). BAVs are associated with unique challenges related to their anatomy, clinical presentation, and association with aortopathy. BAV has a spectrum of phenotypes and the classification is still evolving. There have been no definitive clinical guidelines on triaging BAV patients towards TAVR or SAVR. Given that TAVR is moving from high-risk to low-risk patients and becoming more widely used in the treatment of BAV, there are many factors that must be considered. The aim of this article is to review the literature and present considerations for heart teams to discuss in order to offer patients the best lifetime management strategy for BAV stenosis.

Keywords: Aortic stenosis; aortopathy; bicuspid; surgical aortic valve replacement; transcatheter aortic valve replacement.

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Conflict of interest statement

Disclosure: KBH is a speaker and proctor for Edwards Lifesciences and is on trial steering committees for Abbott. MS is a speaker and proctor for Edwards Lifesciences, is on an advisory board and is a proctor for Abbott, and is on a steering committee for Medtronic. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Bicuspid Valve Classification Using the Sievers Classification
Figure 2:
Figure 2:. Bicuspid Aortic Valve Classification
See this image and copyright information in PMC

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