Bicuspid Aortic Valve Disease: Classifications, Treatments, and Emerging Transcatheter Paradigms

Area of Science:

• Cardiology
• Congenital Heart Disease
• Valvular Heart Disease

Background:

• Bicuspid aortic valve (BAV) is a frequent congenital heart defect.
• BAV can cause early aortic valve disease and aortopathy.
• Transcatheter aortic valve replacement (TAVR) is increasingly used in younger symptomatic BAV patients.

Purpose of the Study:

• To review novel BAV classification systems.
• To examine contemporary surgical and transcatheter approaches for BAV.
• To assess clinical outcomes in BAV patients undergoing TAVR.

Main Methods:

• Literature review of novel BAV classification systems.
• Analysis of contemporary surgical techniques for BAV.
• Evaluation of transcatheter aortic valve replacement (TAVR) in BAV patients.
• Comparison of outcomes between BAV and tricuspid aortic stenosis patients undergoing TAVR.

Main Results:

• Procedural techniques and clinical outcomes have improved for BAV patients undergoing TAVR.
• TAVR shows good clinical results in younger symptomatic BAV patients, despite limited randomized trial evidence.
• BAV patients may have different outcomes compared to tricuspid aortic stenosis patients post-TAVR.

Conclusions:

• Novel BAV classifications are emerging.
• Surgical and transcatheter options for BAV are evolving.
• Further research, including randomized trials, is needed to optimize TAVR in BAV.