TAVR ‘viable and safe’ for patients with a bicuspid valve

Transcatheter aortic valve replacement (TAVR) procedures with a self-expanding artificial valve are “very viable and safe” for low-risk patients with a bicuspid aortic valve, according to new research that tracked the outcomes of 150 patients.

The findings were presented Sunday, March 29, at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC). The 150 patients were treated at 25 different medical centers in the United States and had an average age of 70 years old. The average Society of Thoracic Surgeons risk score was 1.4%.

Researchers found that 30 days following the TAVR procedure, only 1.3% of patients had died or “experienced a disabling stroke.” In addition, 84.6% of patients with Sievers type 0 bicuspid valves had trace aortic regurgitation or regurgitation—among other patients, only mild aortic regurgitation was reported.

“This is the first study that shows the self-expanding valve works well for patients with both type 1 and type 0 bicuspid valves,” Basel Ramlawi, MD, the study’s co-principal investigator and a cardiothoracic surgeon for Valley Health System, said in a statement. “The medical community has perceived type 0 bicuspid valves as more challenging to treat, so those data are especially encouraging.”

The researchers noted that these same patients will be tracked for 10 years to evaluate the long-term effectiveness of TAVR procedures with self-expanding artificial valves.

“Though additional follow-up is necessary to determine long-term outcomes, early results suggest this procedure can be performed successfully in low-risk individuals with a good outcome,” Ramlawi said.

The team also highlighted limitations of its research, including the fact that no comparisons could be made to patients who underwent open-heart surgery instead of TAVR.

Medtronic, the manufacturer of the artificial valves included in the team’s research, funded the study.