Valvular & structural heart disease
Transcatheter Aortic Valve Replacement With Balloon- Versus Self-Expandable Bioprostheses for the Treatment of Bicuspid Aortic Valve Stenosis
Main finding · Death or strokeResult — go to the resultHazard ratio 0.99 95% CI 0.65–1.51Authors' conclusion
In patients undergoing transcatheter aortic valve replacement for bicuspid aortic valve stenosis, death or stroke does not significantly differ between those receiving a BE-THV and those receiving an SE-THV over a follow-up of 3 years.
Study context
- Population
- Consecutive patients undergoing TAVR for CT-diagnosed bicuspid aortic valve stenosis
- Participants
- 1,443 patients29 centres
- Exposure
- TAVR with balloon-expandable vs self-expandable THV
- BE-THVn = 860
- SE-THVn = 583reference
- Outcome
- Death or stroke
- Follow-up
- 3 years
Methodological detailsmulticentre (29 centres), propensity-score matched, multiple imputation, doubly robust adjustment
- Multicentre (29 centres)
- Propensity-score matched
- Multiple imputation
- Doubly robust adjustment
Main finding
As reported in the abstract
Hazard ratio
0.99
95% CI 0.65–1.51
By group
BE-THVvs SE-THV
HR 0.99 (95% CI 0.65–1.51)
Observational data: associations, not effects.
Further findings
| Outcome | BE-THV | SE-THV | HR (95% CI) | |
|---|---|---|---|---|
| In-hospital and 30-day death or stroke · after propensity score matching | 5.1% | 6.1% | 1.02 (0.51–2.02) | |
| 0.512Hazard ratio (log scale) |
Death or stroke across clinical, anatomical, functional and procedural subgroups
- Consistent with the main analysis
Safety
| Outcome | BE-THV | SE-THV | HR (95% CI) | |
|---|---|---|---|---|
| Pacemaker implantation · 30 daysAfter propensity score matching | 11.9% | 18.6% | 0.58 (0.36–0.93) | |
| 0.20.5125Hazard ratio (log scale) |
Procedural complications
- BE-THV: higher annulus rupture and mean transvalvular gradient
- SE-THV: higher additional valve implantation and paravalvular regurgitation
Original publication
Transcatheter Aortic Valve Replacement With Balloon- Versus Self-Expandable Bioprostheses for the Treatment of Bicuspid Aortic Valve Stenosis. Circulation. Published 18 August 2025. doi:10.
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