Challenging Anatomies for TAVR-Bicuspid and Beyond

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter aortic valve replacement (TAVR) is the standard treatment for symptomatic aortic stenosis.
• TAVR is expanding to diverse patient risk groups, necessitating refined selection and implantation strategies.
• Challenging anatomies and clinical indications previously deemed contraindications for TAVR are increasingly encountered.

Purpose of the Study:

• To highlight potential obstacles in clinical practice for transcatheter aortic valve replacement.
• To emphasize challenges associated with bicuspid aortic valve disease in TAVR patients.

Main Methods:

• Review of current clinical practices and literature regarding TAVR.
• Discussion of challenging patient anatomies and indications.
• Focus on specific considerations for bicuspid aortic valve disease.

Main Results:

• Optimal patient selection and device implantation techniques are crucial as TAVR use expands.
• Certain complex anatomies and clinical scenarios present significant challenges for TAVR.
• Bicuspid aortic valve disease represents a notable obstacle requiring specific management strategies.

Conclusions:

• Careful patient selection and advanced implantation techniques are vital for successful TAVR outcomes.
• Addressing challenging anatomies, particularly bicuspid aortic valve disease, is essential for expanding TAVR eligibility.
• Further research and technique refinement are needed to overcome TAVR-related obstacles.