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Outcomes Compared for TAVR in Bicuspid, Tricuspid Aortic Stenosis

No differences seen in mortality, stroke, or other complications for low-risk patients undergoing bicuspid versus tricuspid aortic stenosis

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WEDNESDAY, Sept. 29, 2021 (HealthDay News) -- Transcatheter aortic valve replacement (TAVR) may be an option for some low-risk patients with bicuspid aortic stenosis, according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

Raj R. Makkar, M.D., from the Cedars-Sinai Medical Center in Los Angeles, and colleagues compared the outcomes of TAVR with a balloon-expandable valve for bicuspid versus tricuspid aortic stenosis. The analysis included 3,168 propensity-matched pairs of patients at low surgical risk undergoing TAVR for bicuspid versus tricuspid aortic stenosis.

The researchers observed no significant difference between the bicuspid and tricuspid groups for rates of death at 30 days (0.9 versus 0.8 percent; hazard ratio [HR], 1.18; 95 percent confidence interval [CI], 0.68 to 2.03; P = 0.55) or at one year (4.6 versus 6.6 percent; HR, 0.75; 95 percent CI, 0.55 to 1.02; P = 0.06). Findings were similar for stroke at 30 days (1.4 versus 1.2 percent; HR, 1.14; 95 percent CI, 0.73 to 1.78; P = 0.55) and at one year (2.0 versus 2.1 percent; HR, 1.03; 95 percent CI, 0.69 to 1.53; P = 0.89). No significant differences were seen between the groups for procedural complications, valve hemodynamics, or moderate or severe paravalvular leak.

"Our hope is for this data to translate into better advocacy and decision-making among healthcare providers and patients diagnosed with bicuspid aortic stenosis," Makkar said in a statement. "By carefully selecting low-risk surgical patients with bicuspid aortic stenosis, we can add years to life and life to years."

Several authors disclosed financial ties to the medical device and technology industries.

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