Valvular & structural heart diseaseCohort study
Risk of Aortic Root Rupture in Bicuspid Aortic Stenosis: The ABC Sizing Algorithm for SAPIEN 3 Valves
- retrospective multicenter study
- 15 centers in 7 countries
- case-control (aortic root rupture cases and controls without root complications)
- computed tomography analysis blinded to rupture status
Authors' conclusion
High calcium volume, narrow sinus dimensions, and excessive valve oversizing were associated with aortic root rupture. The ABC algorithm showed promising performance for risk stratification of patients with bicuspid anatomy being considered for treatment with a SAPIEN 3 valve.
Study context
- Population
- Patients with bicuspid aortic stenosis treated with transcatheter aortic valve replacement using SAPIEN 3 valves23 ruptures and 147 controls · ruptures 23 · controls 147
- Participants
- 170 patients
- Exposure
- ABC Bicuspid Sizing Algorithm for the identification of rupture cases
- Casesn = 23
- Controlsn = 147
Main finding
As reported in the abstract
Total calcium volume
P < 0.001
Observational data: associations, not effects.
Further findings
Maximum sinus difference · smaller in cases
P < 0.001
| Outcome | Cases | Controls | P value |
|---|---|---|---|
| Intercommissural distance difference · smaller in cases | median −0.15 mm | median 1.19 mm | P = 0.009 |
| Annular oversizing · greater in cases | median 6.57% | median 3.51% | P = 0.047 |
Diagnostic performance of any high-risk criterion for identification of rupture cases
- Sensitivity
- 100% (95% CI, 85.7%-100%)
- Specificity
- 89.1% (95% CI, 83.1%-93.2%)
- Diagnostic odds ratio
- 374.5 (95% CI, 21.7-6459.9)
- Positive likelihood ratio
- 9.19
- Negative likelihood ratio
- 0.023
Original publication
Risk of Aortic Root Rupture in Bicuspid Aortic Stenosis: The ABC Sizing Algorithm for SAPIEN 3 Valves. Circ Cardiovasc Interv. Published 25 June 2026. doi:10.1161/circinterventions.126.016918
Summarised from the published abstract; every number is checked against it