Successful Transcatheter Aortic Valve Replacement for Bicuspid Aortic Valve

Maeda, Koichi; Kuratani, Toru; Torikai, Kei; Shimamura, Kazuo; Ueno, Takayoshi; Toda, Köichi; Sawa, Yoshiki

doi:10.5761/atcs.cr.12.02182

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…An enlarged root may increase the risk of transcatheter heart valve displacement, distortion, or malfunctioning. 51) One of the main reasons for this is the presumed risk of residual aortic regurgitation (AR) and a higher rate of relevant AR over grade 2 after TAVI was identified among patients with BAV. 52) In addition, it is difficult to dilate the bicuspid valve into a completely circular shape due to the morphology of BAV itself.…”

Section: Clinical Potential On Transcatheter Aortic Valve Implantatiomentioning

confidence: 99%

Current Topics on Bicuspid Aortic Valve: Clinical Aspects and Surgical Management

Furukawa

Tanemoto

2015

ATCS

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IntroductionBicuspid aortic valve (BAV) is a common congenital cardiac malformation, with a reported incidence of between 0.6% and 2% in the general population. 1,2) BAV has been identified as the main cause of aortic valve disease leading to surgical treatment in children and young adults. A large pathological survey revealed that BAV could result in a stenotic lesion in 75% of patients and insufficiency in 15%. 3) Although BAV is often considered to be a benign lesion early in life, the complications associated with cardiovascular diseases, including aortic stenosis (AS), aortic insufficiency (AI), infective endocarditis (IE), and aortic dilation and dissection, can result in marked increases in morbidity and mortality later in life. [4][5][6] Understanding of aortic dilation associated with BAV has evolved with improvements in diagnostic technology and surgical management. 7) There is a growing consensus that the ascending aorta should be replaced at the time of aortic valve replacement for bicuspid aortic valve even if it is only moderately dilated. A recent study that gathered information from a total of 100 Canadian cardiac surgeons reported that surgeons' knowledge and attitudes toward BAV aortopathy influenced their surgical approaches. This large survey revealed significant gaps in the knowledge and attitudes of surgeons toward the diagnosis and management of BAV aortopathy, with approximately one third of cardiac surgeons stating that

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Section: Clinical Potential On Transcatheter Aortic Valve Implantatiomentioning

confidence: 99%

Current Topics on Bicuspid Aortic Valve: Clinical Aspects and Surgical Management

Furukawa

Tanemoto

2015

ATCS

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“…Following the development of transcatheter aortic valve implantation (TAVI), efficacy in patients for whom conventional AVR is not indicated has been reported. [4][5][6] However, there is insufficient data on the efficacy of TAVI in various subgroups of patients, such as Japanese women who tend to have a…”

Section: Introductionmentioning

confidence: 99%

Early and Long-Term Outcomes in Japanese Patients Aged 80 Years or Older Undergoing Conventional Aortic Valve Replacement

Sezai

Osaka

Yaoita

et al. 2015

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In this study, we investigated the early and long-term results of conventional aortic valve replacement (AVR) in very old patients. Methods: Seventy-five patients with aortic stenosis underwent conventional AVR for patients aged 80 years.We examined early death and major adverse cardiovascular and cerebrovascular event (MACCE). Results: The operative mortality was 0% for isolated AVR and 19.2% for concomitant surgery. The postoperative survival rate and MACCE free-rate were no significant differences between the isolated AVR and the concomitant surgery. Univariate analysis confirmed that cardiac dysfunction, severe chronic kidney disease (CKD), hemodialysis, + coronary artery bypass grafting, and norepinephrine use were risk factor of early death. Univariate analysis confirmed that severe CKD, BNP >1000 pg/ml, aortic cross clamping time (ACCT) >180 min, and non-use carperitide and multivariate analysis confirmed that ACCT >180 min, and non-use carperitide were risk factor of MACCE. Conclusions: This study showed that the results of conventional AVR in very old patients were not satisfactory. However, the results obtained with isolated AVR were favorable with no operative deaths. The present study demonstrated that preoperative cardiac function, preoperative renal function, and operative factors have an important impact on early mortality and MACCE.

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Transcatheter aortic valve implantation in bicuspid anatomy

et al. 2014

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Transcatheter aortic valve implantation (TAVI) is an established therapeutic option for high-risk patients with tricuspid aortic valve stenosis. Historically, the presence of a bicuspid aortic valve (BAV) has been regarded as a contraindication to TAVI, on the basis of putative concerns about the associated risks of elliptical deployment, accelerated leaflet degeneration, periprosthetic leaks, and aortic complications. Fortunately, with technological refinements and mounting experience, reasonable success has been achieved with TAVI in selected patients with a BAV. The rate of procedural success is high, and survival is similar to that in patients with a tricuspid aortic valve who undergo TAVI. Nevertheless, moderate or severe aortic regurgitation and aortic dissection seem to occur more frequently in patients with a BAV rather than a tricuspid aortic valve. Specifically-designed prospective studies should address these concerns and help to define anatomical selection criteria before TAVI can be recommended for patients with a BAV.

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Successful Transcatheter Aortic Valve Replacement for Bicuspid Aortic Valve

Cited by 3 publications

References 10 publications

Current Topics on Bicuspid Aortic Valve: Clinical Aspects and Surgical Management

Current Topics on Bicuspid Aortic Valve: Clinical Aspects and Surgical Management

Early and Long-Term Outcomes in Japanese Patients Aged 80 Years or Older Undergoing Conventional Aortic Valve Replacement

Transcatheter aortic valve implantation in bicuspid anatomy

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