Differences in Left Ventricular Remodeling Between Bicuspid Compared to Tricuspid Aortic Valve With Aortic Stenosis...

The study aimed to compare the differences in reverse left ventricular (LV) remodeling following transcatheter aortic valve replacement (TAVR) between patients with the bicuspid aortic valve (BAV) and those with tricuspid aortic valve (TAV), both with aortic stenosis, in a Chinese population.

A total of 137 patients were enrolled who were treated with a self-expandable Venus A valve at our center, who underwent TAVR from January 1, 2019, to June 30, 2022. We retrospectively included patients with BAV and TAV who underwent echocardiographic follow-ups at baseline and at least 6 months after the procedure.

Patients with a BAV were younger than those with a TAV. The BAV patients had a larger aortic root diameter (ARD), although the size of valve implantation was comparable between the two groups. Patients with a BAV might experience less reverse LV remodeling post-TAVR than patients with a TAV during the one-month follow-up (140.09 ± 36.94 g/m² vs. 126.36 ± 26.96 g/m²; p = 0.044). There were no significant differences in the LV mass index (LVMi) between the two groups throughout the 24 hours or the six-month follow-up post-TAVR. Patients with a higher mean pressure gradient (MPG) (95% confidence interval (CI): 0.112-0.581; p = 0.004) and a larger ARD (95% CI: 0.519-5.573; p = 0.019) before TAVR had favorable mid-term LV reverse remodeling (ΔLVMi within 6 months) post-TAVR. Patients with much more severe aortic stenosis (AS) had favorable mid-term LV reverse remodeling post-TAVR.

Patients with BAV might experience less reverse LV remodeling post-TAVR than patients with TAV during a short-term follow-up, but similar remodeling during mid-term follow-ups.