Anatomical characteristics of patients with symptomatic severe aortic stenosis in China

Xiong, Tian-Yuan; Li, Yiming; Yao, Yijun; Jia, Yixin; Xu, Kai; Fang, Zhenfei; Jin, Jun; Fu, Guosheng; Yang, Yi‐Ning; Jiang, Lei; Li, Weidong; Wu, Yanqing; Guo, Yan-Song; Guo, Ran; Chen, Yundai; Li, Yang; Shao, Yang; Zhang, Yi; Yang, Bosen; Zhang, Yi-Ke; He, Jingjing; Jia, Kaiyu; He, Shenghu; Ren, Fuqiang; Xiu, Jiancheng; Gu, Xiang; Chen, Lianglong; Han, Ke; Feng, Yuan; Chen, Mao

doi:10.1097/cm9.0000000000001863

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…High residual gradient in type 0 BAV may be related to more burden of leaflet calcification than the type 1 BAV cohort 15 and constraint from the typical fish mouth shape of the leaflet opening. 20 Being normally oval, the minimum sinus of Valsalva diameter likely determines the extent of valve expansion.…”

Section: Discussionmentioning

confidence: 97%

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Outcomes Following Transcatheter Aortic Valve Replacement for Aortic Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid Aortic Valves

He,

Xiong,

Yao

et al. 2023

Circ: Cardiovascular Interventions

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BACKGROUND: Data concerning the outcomes of transcatheter aortic valve replacement in type 0 bicuspid aortic stenosis (AS) are scarce. The study aims to compare the outcomes of transcatheter aortic valve replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy. METHODS: We enrolled consecutive patients undergoing transcatheter aortic valve replacement for severe AS between 2012 and 2022 in this single-center retrospective cohort study. The primary outcome was mortality, while secondary outcomes included in-hospital complications such as stroke and pacemaker implantation and transcatheter heart valve hemodynamic performance. RESULTS: The number of patients with AS with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy was 328, 302, and 642, respectively. Self-expanding transcatheter heart valves were used in the majority of patients (n=1160; 91.4%). In the matched population, differences in mortality (30 days: 4.2% versus 1.7% versus 1.7%, P overall =0.522; 1 year: 10% versus 2.3% versus 6.2%, P overall =0.099) and all stroke (30 days: 1.0% versus 0.9% versus 0.0%, P overall =0.765; 1 year: 1.4% versus 1.6% versus 1.3%, P overall =NS) were nonsignificant, and the incidence of overall in-hospital complications was comparable among groups. Ascending aortic diameter was the single predictor of 1-year mortality in type 0 bicuspid patients (hazard ratio, 1.59 [95% CI, 1.03–2.44]; P =0.035). The proportion of patients with a mean residual gradient ≥20 mm Hg was the highest in those with type 0 bicuspid anatomy, although the need for permanent pacemaker implantation was the lowest in this group. CONCLUSIONS: Major clinical outcomes of transcatheter aortic valve replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy are equivalent at short- and mid-term follow-up. These observations merit further exploration in prospective international registries and randomized controlled trials.

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Section: Discussionmentioning

confidence: 97%

“…Although type 0 BAV accounts for <15% of western BAV populations undergoing TAVR, it is encountered much more frequently in China, constituting about 42.5% of bicuspid AS patients. 15 It is unclear whether the western community would face more type 0 BAV when the age of patients further decreases.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Following Transcatheter Aortic Valve Replacement for Aortic Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid Aortic Valves

He,

Xiong,

Yao

et al. 2023

Circ: Cardiovascular Interventions

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“…Additionally, a higher calcium load is positively associated with an increased risk of annular rupture [ 16 ]. The calcium load of the aortic valve in general is higher in patients with BAV [ 27 , 28 ]. Furthermore, in TAVR, increased amounts of annular and leaflet calcium predict PVL [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Different calcification patterns of tricuspid and bicuspid aortic valves and their clinical impact

Gollmann‐Tepeköylü

Nägele

Engler

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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Objectives Mechanical strain plays a major role in the development of aortic calcification. We hypothesized that (a) valvular calcifications are most pronounced at the localizations subjected to the highest mechanical strain and (b) calcification patterns are different in patients with bicuspid and tricuspid aortic valves. Methods Multi slice computed tomography scans of 101 patients with severe aortic stenosis were analyzed using a 3D-post processing software to quantify calcification of tricuspid aortic valves (n = 51) and bicuspid aortic valves (n = 50) after matching. Results BAV exhibited higher calcification volumes and increased calcification of the non-coronary cusp with significantly higher calcification of the free leaflet edge. The non-coronary cusp showed the highest calcium load compared to the other leaflets. Patients with annular calcification above the median had an impaired survival compared to patients with low annular calcification, whereas calcification of the free leaflet edge above the median did not (p = 0.53). Conclusion Calcification patterns are different in aortic stenosis patients with bicuspid and tricuspid aortic valves. Patients with high annular calcification might have an impaired prognosis.

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Sex Difference in Outcomes Following Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis

Xiong²,

Yao³

et al. 2022

JACC: Cardiovascular Interventions

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Anatomical characteristics of patients with symptomatic severe aortic stenosis in China

Cited by 7 publications

References 8 publications

Outcomes Following Transcatheter Aortic Valve Replacement for Aortic Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid Aortic Valves

Outcomes Following Transcatheter Aortic Valve Replacement for Aortic Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid Aortic Valves

Different calcification patterns of tricuspid and bicuspid aortic valves and their clinical impact

Sex Difference in Outcomes Following Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis

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