The feasibility of transcatheter aortic valve implantation using the Edwards SAPIEN 3 for patients with severe bicuspid aortic stenosis

Background There are currently only limited data focusing on transcatheter aortic valve implantation (TAVI) for bicuspid aortic valves (BAV) patients using the Edwards SAPIEN (Irvine, CA, USA) 3 (S3) valve. The aim of this study was to evaluate the feasibility and efficacy of TAVI using the S3 in patients with BAV. Methods A total of 153 TAVI cases performed with the S3 were included. BAV was detected by multidetector computed tomography (MDCT) in 10 (7%) patients. The other patients had tricuspid aortic valves (TAV). The BAV and TAV groups were compared. Results Patient age and logistic EuroSCORE were similar in the BAV and TAV groups. The calculated annulus average diameter (CAAD) by MDCT was significantly larger in the BAV group (26.5 mm vs 23.7 mm, p = 0.036) as was the annular area by MDCT (562 mm² vs 446 mm², p = 0.033). On the other hand, the valve diameter/CAAD ratio was significantly lower in the BAV group (1.01 vs 1.06, p = 0.010) as was the annular area oversizing percentage (3% vs 11%, p = 0.033). There were no significant differences between the two groups regarding the frequency of paravalvular aortic leakage (PVL) ≥2 (0% vs 6%, p = 0.492) and the 30-day mortality rate (0% vs 1%, p = 0.799). Conclusions Although TAVI for BAV tended to be carried out with a less oversized valve compared to TAVI for TAV, the frequency of post-procedural PVL ≥2 was similarly low in the two groups. TAVI using the S3 in patients with BAV seems to be feasible.