Valvular & structural heart disease
Outcomes of transcatheter aortic valve replacement in bicuspid versus tricuspid aortic stenosis with severe calcification
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.87Authors' conclusion
TAVR was observed to be equally safe and effective in bicuspid and tricuspid AS with severe calcification, though bicuspid AS was associated with a higher rate of permanent pacemaker implantation.
Study context
- Population
- Patients with severe calcification (≥470 mm³) undergoing transcatheter aortic valve replacement (TAVR), Chinese national TAVR registry, April 2014–August 2023870 matched pairs
- Participants
- 870 vs 870
- Exposure
- TAVR in bicuspid vs tricuspid aortic stenosis (AS)
- Bicuspid ASn = 870
- Tricuspid ASn = 870reference
- Outcome
- All-cause mortality
- Follow-up
- 1 year
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
As reported in the abstract
Hazard ratio
0.87
P = 0.62
By group
Observational data: associations, not effects.
Further findings
Technical success
- Technical success, bicuspid vs tricuspid AS (no significant difference)
- 95.1% vs 94.7%
- Propensity score matched
Procedural complications and in-hospital outcomes
- No significant differences in procedural complications or in-hospital outcomes
CV hospitalisation · during follow-up
- CV hospitalisation, bicuspid vs tricuspid AS (similar)
- 1.4% vs 1.7%
Safety
| Outcome | P value |
|---|---|
| New permanent pacemaker implantation8.4% vs 5.6%; higher in bicuspid AS | P = 0.03 |
Stroke · during follow-up
- Stroke, bicuspid vs tricuspid AS (similar)
- 1.5% vs 1.4%
Moderate-to-severe paravalvular leak · during follow-up
- Moderate-to-severe paravalvular leak, bicuspid vs tricuspid AS (similar)
- 3.5% vs 2.5%
Original publication
Outcomes of transcatheter aortic valve replacement in bicuspid versus tricuspid aortic stenosis with severe calcification. Heart. Published 10 May 2025. doi:10.
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