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Updated: May 8, 2026
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Successful transcatheter aortic valve replacement for bicuspid aortic valve
Koichi Maeda1, Toru Kuratani, Kei Torikai
1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Summary
Transcatheter aortic valve replacement (TAVR) is a viable treatment for bicuspid aortic valves (BAV). A novel implantation technique successfully addressed challenges associated with BAV anatomy, ensuring optimal valve function.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Bicuspid aortic valve (BAV) presents unique challenges for transcatheter aortic valve replacement (TAVR) due to anatomical variations.
- Increased risks of device displacement, distortion, or malfunction are associated with BAV anatomy during TAVR.
Observation:
- A case of successful TAVR in an 84-year-old male patient with a bicuspid aortic valve is presented.
- A modified implantation strategy was employed, positioning the transcatheter heart valve (THV) closer to the aorta.
Findings:
- The adjusted THV implantation successfully avoided interference with bulky BAV leaflets.
- Post-procedure assessment revealed only trivial paravalvular leakage, with no THV distortion or malfunction.
Implications:
- This case demonstrates the feasibility of TAVR in complex BAV anatomies with a tailored approach.
- The modified implantation technique may offer a solution for mitigating risks in BAV patients undergoing TAVR.
