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Abstract
Background The comparative outcomes of transcatheter aortic valve replacement (TAVR) in bicuspid versus tricuspid aortic stenosis (AS) with severe calcification remain unclear. This study aimed to compare the safety and efficacy of TAVR in these patient groups.
Methods Using data from the Chinese Cardiovascular Association Database—National Transcatheter Valve Therapeutics Registry, we analysed 870 propensity score matched pairs of patients with severe calcification (≥470 mm³) undergoing TAVR between April 2014 and August 2023. Primary outcome was all-cause mortality at 1 year.
Results No significant differences were observed in technical success (95.1% vs 94.7%), procedural complications or in-hospital outcomes. All-cause mortality at 1 year was similar between bicuspid and tricuspid AS (4.3% vs 5.3%, HR 0.87; log-rank p=0.62). The incidence of stroke (1.5% vs 1.4%), cardiovascular hospitalisation (1.4% vs 1.7%) and moderate-to-severe paravalvular leak (3.5% vs 2.5%) was similar during follow-up. The rate of new permanent pacemaker implantation was higher in bicuspid AS (8.4% vs 5.6%; p=0.03).
Conclusions TAVR was observed to be equally safe and effective in bicuspid and tricuspid AS with severe calcification, though bicuspid AS was associated with a higher rate of permanent pacemaker implantation.
- Aortic stenosis
- Bicuspid aortic valve
- Transcatheter Aortic Valve Replacement
Data availability statement
Data are available on reasonable request.
Statistics from Altmetric.com
Data availability statement
Data are available on reasonable request.
Footnotes
Contributors YS, CW, JLu and JLi contributed to conception and design of the study. YS and CW organised the database, performed the statistical analysis and wrote the first draft of the manuscript. All authors contributed to the revision of the article and approved the submitted version. YS is the guarantor.
Funding This research was funded by the Startup Project of the National Natural Science Foundation of China (8200020121), Guangzhou Clinical Major Technical Project (2025FTJCZ0017), Guangzhou Science and Technology Project (2023B03J1256) and the National Natural Science Foundation of China (82100382).
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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