Valvular & structural heart diseaseResearch article
Risk of Coronary Obstruction in Redo-Transcatheter Aortic Valve Replacement Between Bicuspid and Tricuspid Aortic Valves
- Computed tomographic (CT) simulation study
Authors' conclusion
Redo-TAV simulation using post-TAVR CT imaging performed at 30 days suggested higher redo-TAV feasibility in patients with bicuspid aortic valves compared with tricuspid aortic valves.
Study context
- Population
- Post-TAVR CT studies of patients treated with SAPIEN 3/S3 Ultra (S3) or Evolut R/PRO/PRO+ (Evolut) valvespost-TAVR CT studies
- Participants
- 913 studies
- Comparison
- Bicuspid vs tricuspid aortic valves
- Bicuspidn = 59
- Outcome
- Redo-TAV feasibility (risk to coronary arteries), by neoskirt plane vs coronary risk plane or sinotubular junction and narrowest valve-to-aorta distances
Main finding
As reported in the abstract
Redo-TAV feasibility
- Narrowest valve-to-aorta distances longer in bicuspid cases, with higher redo-TAV feasibility for S3-in-S3 and Evolut-in-S3
- Similar trends for S3-in-Evolut and Evolut-in-Evolut; feasibility tended to be higher in bicuspid cases
Further findings
| Outcome | Bicuspid | Tricuspid |
|---|---|---|
| Aortic root anatomy | ||
| Annular area | 522 mm² [Q1-Q3: 461-597 mm²] | 479 mm² [Q1-Q3: 416-551 mm²] |
| Sinus of Valsalva diameter | 34 mm [Q1-Q3: 31-36 mm] | 32 mm [Q1-Q3: 30-35 mm] |
| Sinotubular junction diameter | 30 mm [Q1-Q3: 28-33 mm] | 29 mm [Q1-Q3: 27-31 mm] |
- Aortic root anatomy: P < 0.05 for all
Aortic root anatomy
- Bicuspid patients younger with lower surgical risk
Original publication
Risk of Coronary Obstruction in Redo-Transcatheter Aortic Valve Replacement Between Bicuspid and Tricuspid Aortic Valves. JACC Cardiovasc Interv. Published 12 May 2025. doi:10.1016/j.jcin.2025.02.016
Summarised from the published abstract; every number is checked against it