Valvular & structural heart diseaseMeta-analysis
Transcatheter Aortic Valve Replacement for Severe Bicuspid Aortic Valve Stenosis
- Random-effects meta-analysis
- exploratory meta-regression
Authors' conclusion
TAVR for BAV stenosis was associated with procedural risk than TAVR for TAV stenosis but lower 1-year mortality. Compared with SAVR, TAVR showed procedural trade-offs without early mortality differences.
Study context
- Population
- Patients with bicuspid aortic valve (BAV) stenosis undergoing transcatheter aortic valve replacement (TAVR), compared with tricuspid aortic valve (TAV) stenosis or with surgical aortic valve replacement (SAVR)Fifty-two studies were included · studies comparing TAVR in BAV vs TAV 39 · studies comparing TAVR vs SAVR in BAV 13
- Comparison
- BAV vs TAV
Pooled result
Paravalvular leak (TAVR in BAV vs TAV)
Relative risk
1.44
95% CI 1.18–1.77
P < 0.001
BAV vs TAV
RR 1.44 (95% CI 1.18–1.77); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Aortic root injury (TAVR in BAV vs TAV) | 1.83 (1.10–3.04) | P = 0.020 | |
| Stroke (TAVR in BAV vs TAV) · 30-day | 1.27 (1.02–1.59) | P = 0.035 | |
| Mortality (TAVR in BAV vs TAV) · 30-day | 1.25 (1.00–1.55) | P = 0.047 | |
| Mortality (TAVR in BAV vs TAV) · 1-year · lower with BAV | 0.84 (0.75–0.94) | P = 0.002 | |
| Paravalvular leak (TAVR vs SAVR in BAV) | 7.08 (2.28–21.98) | P < 0.001 | |
| Major bleeding (TAVR vs SAVR in BAV) · lower with TAVR | 0.27 (0.17–0.44) | P < 0.001 | |
| 0.050.21520Relative risk (log scale) |
Stroke and mortality (TAVR vs SAVR in BAV) · 30-day
- similar 30-day stroke
- P = 0.288
- similar mortality
- P = 0.452
Predictor of 1-year mortality (meta-regression)
- Society of Thoracic Surgeons score (not BAV anatomy) predicted 1-year mortality, RR
- 1.31; 95% CI: 1.08-1.59; P = 0.006
- exploratory meta-regression
Temporal trend in BAV outcomes
- BAV outcomes improved in recent studies, RR per year
- 0.93; 95% CI: 0.87-1.00; P = 0.048
- exploratory meta-regression
Original publication
Transcatheter Aortic Valve Replacement for Severe Bicuspid Aortic Valve Stenosis. JACC Adv. doi:10.1016/j.jacadv.2026.103052
Summarised from the published abstract; every number is checked against it