Related Experiment Video

Updated: Jul 7, 2026

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
09:57

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement

Published on: January 20, 2022

2.6K

Impact of Balloon-Expandable TAVR Valve Deformation and Calcium Distribution on Outcomes in Bicuspid Aortic Valve

Takashi Nagasaka1, Vivek Patel2, Alon Shechter3

  • 1Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA; Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.

JACC. Cardiovascular Interventions
|September 11, 2024
PubMed

Insights

Transcatheter heart valve deformation after TAVR increases mortality in bicuspid aortic valve patients. Annular and outflow tract calcification also heighten risks for mortality and leaflet thrombosis.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Limited research exists on transcatheter heart valve (THV) deformation and calcium distribution in bicuspid aortic valve (BAV) patients undergoing transcatheter aortic valve replacement (TAVR).
  • Understanding these factors is crucial for improving TAVR outcomes in this specific patient population.

Purpose of the Study:

  • To evaluate the impact of THV deformation on clinical outcomes in BAV patients undergoing TAVR.
  • To assess the influence of calcium distribution on these outcomes, including mortality and leaflet thrombosis.

Main Methods:

  • Analysis of 229 BAV patients who underwent TAVR with balloon-expandable valves and had post-TAVR computed tomography (CT).
  • Patients were stratified based on THV underexpansion or eccentricity.
  • Calcium distribution was assessed via CT, and associations with 3-year all-cause mortality and 30-day leaflet thrombosis were determined.

Main Results:

  • Patients with both THV deformation and eccentricity had higher all-cause mortality and leaflet thrombosis risk.
  • Annular and left ventricular outflow tract calcification were independent predictors of mortality and leaflet thrombosis.
  • In type 1 BAV patients, calcification at the raphe and opposite leaflet correlated with 3-year all-cause mortality.

Conclusions:

  • THV deformation post-TAVR is significantly associated with increased all-cause mortality in BAV patients.
  • Annular and left ventricular outflow tract calcification are linked to higher risks of mortality and leaflet thrombosis after TAVR in BAV patients.
Abstract

Keywords:
bicuspid aortic valvehypoattenuated leaflet thickeningtranscatheter aortic valve replacement

More Related Videos

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

1.5K
A Rabbit Aortic Valve Stenosis Model Induced by Direct Balloon Injury07:10

A Rabbit Aortic Valve Stenosis Model Induced by Direct Balloon Injury

Published on: March 31, 2023

974

Related Concept Videos

Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...