TAVR in bicuspid aortic valve stenosis: "We are not there yet" to draw final conclusions

TAVR for bicuspid AS is not associated with excess mortality, but paravalvular leak and pacemaker implant is increased compared to tricuspid AS cohorts undergoing TAVR. Operators should weigh these potential complications against the clinical benefit obtained with TAVR for bicuspid AS patients at high surgical risk. A randomized controlled trial comparing TAVR with SAVR in younger, low-surgical risk patients with-or at least not excluding-bicuspid AS is strongly needed.