JACC. Cardiovascular interventions
September 1, 2026 · via Europe PMC
Long-Term Outcomes of Contemporary Balloon-Expandable TAVR in Bicuspid Aortic Valve: A Propensity-Matched Comparison to Tricuspid.
Suruga K, Patel V, Shitan H, +17 more, Makkar RR.
AI summary — for doctors, generated from the abstract only
In a large propensity-matched comparison, 5-year outcomes after balloon-expandable TAVR were similar between patients with bicuspid versus tricuspid aortic valve anatomy, including mortality, stroke, valve function, and aortic growth rates.
What was studied
A propensity score-matched comparison of 515 matched pairs of patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) with contemporary balloon-expandable valves (2015-2023), comparing 5-year clinical outcomes and valve performance between patients with bicuspid versus tricuspid aortic valve leaflet morphology.
Key findings
- Over a median follow-up of about 4.1 years, there was no significant difference in all-cause mortality between bicuspid and tricuspid groups (13.2% vs 13.7%, p=0.384).
- Heart failure rehospitalization, stroke, and aortic valve reintervention rates at 5 years were not significantly different between groups.
- Valve hemodynamics through 5 years, including mean transvalvular gradients, effective orifice area, and moderate or greater paravalvular leak, as well as ascending aortic growth rates, showed no statistically significant differences between bicuspid and tricuspid patients.
Clinical relevance
These findings suggest that TAVR with contemporary balloon-expandable valves can achieve comparable long-term outcomes and valve performance in patients with bicuspid aortic valve anatomy as in those with the more commonly treated tricuspid anatomy, which could support broader consideration of TAVR in appropriately selected bicuspid valve patients.
Who should care
Limitations
This is a retrospective, propensity-matched observational comparison rather than a randomized trial, so residual confounding from unmeasured anatomical or clinical differences cannot be fully excluded.
Patients with an unusual two-flap aortic valve shape did just as well with a catheter-based valve replacement over 5 years as patients with the typical three-flap valve anatomy.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Limited data are available comparing clinical outcomes between bicuspid and tricuspid patients following transcatheter aortic valve replacement (TAVR).
Objectives
This study sought to investigate 5-year clinical outcomes in patients with severe aortic stenosis following TAVR with contemporary balloon-expandable valves (BEVs) in patients with bicuspid vs tricuspid leaflet morphology.
Methods
From August 2015 to December 2023, a total of 3,393 patients with native aortic stenosis who underwent TAVR with contemporary BEVs were divided into bicuspid and tricuspid groups. A 1:1 propensity score-matched analysis was performed to adjust for baseline differences. The primary endpoint was all-cause mortality at 5-year follow-up.
Results
Among 515 matched pairs, over a median follow-up duration of 1,511 days (Q1-Q3: 937-1825 days), there were no significant differences in all-cause mortality (13.2% vs 13.7%; P = 0.384). Heart failure rehospitalization (8.5% vs 6.8%; P = 0.622), stroke (2.4% vs 2.6%; P = 0.618), or aortic valve reintervention (0.7% vs 1.6%; P = 0.706) at 5 years was not significantly different between the groups. Ascending aortic growth rates (0.37 mm/y vs 0.31 mm/y; P = 0.578), in-hospital death (0.8% vs 1.0%; P = 0.738), valve hemodynamics through 5 years, including mean transvalvular gradients (12.0 mm Hg vs 11.5 mm Hg; P = 0.863), effective orifice area (1.35 cm2 vs 1.50 cm2, P = 0.084), and moderate or greater paravalvular leak (3.9% vs 5.6%; P = 0.578) did not differ significantly between groups.
Conclusions
In propensity score-matched patients undergoing TAVR with contemporary BEVs, long-term clinical outcomes, valve performance, and ascending aortic growth rate showed no statistically significant differences between bicuspid and tricuspid groups.
DOI
10.1016/j.jcin.2026.06.015
PMID
42735974
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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