AIMS: The aim of this study was to assess the performance of a self-expanding valve in bicuspid aortic valve (BAV) stenosis. METHODS AND RESULTS: An international registry included a total of 712 patients with aortic stenosis treated with the ACURATE neo in bicuspid (n=54; 7.5%) or tricuspid (n=658; 92.4%) anatomy. The overall mean age was 81±5.6 years. At baseline, no significant differences were found between the two groups. BAV more frequently required both predilatation (94.4% vs. 78.1%, p=0.004) and post-dilation (57.4% vs. 38.7%, p=0.007). Moderate perivalvular regurgitation was more frequently found in patients with BAV (7.4% vs. 3.18%, p=0.0001). After propensity score matching (PSM), the rate of predilation and post-dilation was confirmed to be higher in the BAV group (94.4% vs. 66.6%, p=0.001, and 57.4% vs. 37.1%, p=0.034, respectively), while the incidence of moderate perivalvular regurgitation was similar between the two groups (BAV 3.1% vs. 5.5% in tricuspid anatomy, p=0.734). In unmatched cohorts, the 30-day outcome showed a higher rate of stroke in the BAV group (7.4% vs. 1.8%, p=0.001). After adjustment for PSM quintiles, the rate of stroke resulted in being similar (odds ratioadj 1.20, 95% confidence interval [CI]: 0.81-1.76, p=0.819). The other 30-day clinical endpoints were similar between the two populations. CONCLUSIONS: This preliminary analysis shows that the use of the ACURATE neo in bicuspid aortic valves is feasible and has acceptable 30-day outcomes. Larger studies are needed to confirm our preliminary findings.
AIMS: The aim of this study was to assess the performance of a self-expanding valve in bicuspid aortic valve (BAV) stenosis. METHODS AND RESULTS: An international registry included a total of 712 patients with aortic stenosis treated with the ACURATE neo in bicuspid (n=54; 7.5%) or tricuspid (n=658; 92.4%) anatomy. The overall mean age was 81±5.6 years. At baseline, no significant differences were found between the two groups. BAV more frequently required both predilatation (94.4% vs. 78.1%, p=0.004) and post-dilation (57.4% vs. 38.7%, p=0.007). Moderate perivalvular regurgitation was more frequently found in patients with BAV (7.4% vs. 3.18%, p=0.0001). After propensity score matching (PSM), the rate of predilation and post-dilation was confirmed to be higher in the BAV group (94.4% vs. 66.6%, p=0.001, and 57.4% vs. 37.1%, p=0.034, respectively), while the incidence of moderate perivalvular regurgitation was similar between the two groups (BAV 3.1% vs. 5.5% in tricuspid anatomy, p=0.734). In unmatched cohorts, the 30-day outcome showed a higher rate of stroke in the BAV group (7.4% vs. 1.8%, p=0.001). After adjustment for PSM quintiles, the rate of stroke resulted in being similar (odds ratioadj 1.20, 95% confidence interval [CI]: 0.81-1.76, p=0.819). The other 30-day clinical endpoints were similar between the two populations. CONCLUSIONS: This preliminary analysis shows that the use of the ACURATE neo in bicuspid aortic valves is feasible and has acceptable 30-day outcomes. Larger studies are needed to confirm our preliminary findings.
Authors: Tian-Yuan Xiong; Walid Ben Ali; Yuan Feng; Kentaro Hayashida; Hasan Jilaihawi; Azeem Latib; Michael Kang-Yin Lee; Martin B Leon; Raj R Makkar; Thomas Modine; Christoph Naber; Yong Peng; Nicolo Piazza; Michael J Reardon; Simon Redwood; Ashok Seth; Lars Sondergaard; Edgar Tay; Didier Tchetche; Wei-Hsian Yin; Mao Chen; Bernard Prendergast; Darren Mylotte Journal: Nat Rev Cardiol Date: 2022-06-20 Impact factor: 32.419
Authors: Ole de Backer; Tobias Zeus; Verena Veulemans; Philippe Nuyens; Shouheng Goh; Oliver Maier; Stephan Binnebößel; Jacqueline Heermann; Christian Jung; Ralf Westenfeld; Malte Kelm Journal: Clin Res Cardiol Date: 2022-06-29 Impact factor: 5.460