Valvular & structural heart diseaseCohort study
Outcomes of Transcatheter Aortic Valve Replacement in Patients With Bicuspid Aortic Valve Disease
- Registry-based cohort study
- multicentre
- Medicare-linked
Authors' conclusion
Using current-generation devices, procedural, postprocedural, and 1-year outcomes were comparable following TAVR for bicuspid AV versus tricuspid AV disease.
Study context
- Population
- Patients undergoing transcatheter AV replacement (TAVR) in the STS/ACC TVT Registry, November 2011 through November 2018procedures at 593 sites
- Participants
- 170,959 patients
- Exposure
- TAVR in bicuspid vs tricuspid aortic valve (AV) stenosis
- Bicuspidn = 5,412
- Outcome
- Device success, procedural outcomes, post-TAVR valve performance and in-hospital outcomes (mortality, stroke, major bleeding); mortality and stroke to 1 year (Medicare, ≥65 years)
Main finding
As reported in the abstract
Device success, current-generation devices
P = 0.07
Observational data: associations, not effects.
Further findings
Residual moderate or severe aortic insufficiency, current-generation devices
P < 0.001
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Mortality (adjusted), Medicare-linked cohort · 1 year | 0.88 (0.78–0.99) | ||
| Stroke (adjusted), Medicare-linked cohort · 1 year | 1.14 (0.94–1.39) | ||
| 0.512Hazard ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Bicuspid AV: current- vs older-generation devices — Current-generation vs Older-generation · device success 93.5 (older) versus 96.3 (current) | P = 0.001 | |
| Bicuspid AV: current- vs older-generation devices — Current-generation vs Older-generation · 2+ aortic insufficiency 14.0% (older) versus 2.7% (current) | P < 0.001 |
Original publication
Outcomes of Transcatheter Aortic Valve Replacement in Patients With Bicuspid Aortic Valve Disease. Circulation. Published 26 February 2020. doi:10.1161/circulationaha.119.040333
Summarised from the published abstract; every number is checked against it