Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR

Weiya Li; Yuheng Jia; Hongde Li; Yusuke Kobari; Junli Li; Yuan Feng; Yong Peng; Jiafu Wei; Zhengang Zhao; Tianyuan Xiong; Haoran Yang; Chengxiang Song; Wenhua Lei; Shiqin Peng; Yue Yin; Xuechen Qiao; Duolao Wang; Won Keun Kim; Ole De Backer; Mao Chen

doi:10.1016/j.jcin.2025.05.045

Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR

Weiya Li
, Yuheng Jia
, Hongde Li
, Yusuke Kobari
, Junli Li
, Yuan Feng
, Yong Peng
, Jiafu Wei
, Zhengang Zhao
, Tianyuan Xiong
, Haoran Yang
, Chengxiang Song
, Wenhua Lei
, Shiqin Peng
, Yue Yin
, Xuechen Qiao
, Duolao Wang
, Won Keun Kim
, Ole De Backer
, Mao Chen

Clinical Sciences

Sichuan University
University of Copenhagen
Kerckhoff Heart Center

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Background: Differences in long-term clinical outcomes following transcatheter aortic valve replacement (TAVR) in different anatomical subtypes of aortic valve stenosis (AS), specifically tricuspid aortic valves (TAV) and bicuspid aortic valves (BAV) of types 0 (BAV-0) and 1 (BAV-1), are not well understood. Objectives: The authors sought to report and compare the long-term clinical outcomes among patients with different anatomical subtypes of AS undergoing TAVR.

Methods: We conducted an international retrospective cohort study involving patients who underwent TAVR for severe AS at 3 large, high-volume heart centers in China, Germany, and Denmark before October 2018. Five-year follow-up ended on October 30, 2023, and the primary endpoint was all-cause mortality.

Results: A total of 2,553 AS patients (BAV-0: n = 134; BAV-1: n = 305; TAV: n = 2,114) who underwent TAVR more than 5 years ago were included. The mean age of this cohort was 79.9 ± 6.8 years, and the median Society of Thoracic Surgeons score was 3.6% [Q1-Q3: 2.4%-5.4%]. The median follow-up time was 3.24 years (Q1-Q3: 1.25-5.00 years). At 5 years, BAV-1 (adjusted HR: 2.38 [95% CI: 1.32-4.28]; P = 0.004) and TAV (adjusted HR: 3.02 [95% CI: 1.71-5.31]; P < 0.001) had a higher risk for all-cause mortality after TAVR compared with BAV-0. BAV patients who were treated with balloon-expandable valves had a higher long-term all-cause mortality (41.7% [28.5%-52.5%] vs 23.6% [17.9%-28.8%]; HR: 1.63 [95% CI: 1.05-2.51]; P = 0.028) compared with those with self-expanding valves.

Conclusions: Among patients with severe AS undergoing TAVR, BAV-0 was associated with a better long-term prognosis compared with TAV and BAV-1.

Original language	English
Pages (from-to)	1881-1892
Number of pages	12
Journal	JACC: Cardiovascular Interventions
Volume	18
Issue number	15
DOIs	https://doi.org/10.1016/j.jcin.2025.05.045
Publication status	Published - 23 Jul 2025

Keywords

all-cause mortality
aortic valve stenosis
bicuspid aortic valve
transcatheter tricuspid valve replacement

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10.1016/j.jcin.2025.05.045

Manuscript-clean versionAccepted author manuscript, 355 KBLicence: CC BY

Cite this

Li, W., Jia, Y., Li, H., Kobari, Y., Li, J., Feng, Y., Peng, Y., Wei, J., Zhao, Z., Xiong, T., Yang, H., Song, C., Lei, W., Peng, S., Yin, Y., Qiao, X., Wang, D., Kim, W. K., De Backer, O., & Chen, M. (2025). Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR. JACC: Cardiovascular Interventions, 18(15), 1881-1892. https://doi.org/10.1016/j.jcin.2025.05.045

@article{5a058abdae334919850e66f5cdb1fbc4,

title = "Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR",

abstract = "Background: Differences in long-term clinical outcomes following transcatheter aortic valve replacement (TAVR) in different anatomical subtypes of aortic valve stenosis (AS), specifically tricuspid aortic valves (TAV) and bicuspid aortic valves (BAV) of types 0 (BAV-0) and 1 (BAV-1), are not well understood. Objectives: The authors sought to report and compare the long-term clinical outcomes among patients with different anatomical subtypes of AS undergoing TAVR. Methods: We conducted an international retrospective cohort study involving patients who underwent TAVR for severe AS at 3 large, high-volume heart centers in China, Germany, and Denmark before October 2018. Five-year follow-up ended on October 30, 2023, and the primary endpoint was all-cause mortality. Results: A total of 2,553 AS patients (BAV-0: n = 134; BAV-1: n = 305; TAV: n = 2,114) who underwent TAVR more than 5 years ago were included. The mean age of this cohort was 79.9 ± 6.8 years, and the median Society of Thoracic Surgeons score was 3.6\% [Q1-Q3: 2.4\%-5.4\%]. The median follow-up time was 3.24 years (Q1-Q3: 1.25-5.00 years). At 5 years, BAV-1 (adjusted HR: 2.38 [95\% CI: 1.32-4.28]; P = 0.004) and TAV (adjusted HR: 3.02 [95\% CI: 1.71-5.31]; P < 0.001) had a higher risk for all-cause mortality after TAVR compared with BAV-0. BAV patients who were treated with balloon-expandable valves had a higher long-term all-cause mortality (41.7\% [28.5\%-52.5\%] vs 23.6\% [17.9\%-28.8\%]; HR: 1.63 [95\% CI: 1.05-2.51]; P = 0.028) compared with those with self-expanding valves. Conclusions: Among patients with severe AS undergoing TAVR, BAV-0 was associated with a better long-term prognosis compared with TAV and BAV-1.",

keywords = "all-cause mortality, aortic valve stenosis, bicuspid aortic valve, transcatheter tricuspid valve replacement",

author = "Weiya Li and Yuheng Jia and Hongde Li and Yusuke Kobari and Junli Li and Yuan Feng and Yong Peng and Jiafu Wei and Zhengang Zhao and Tianyuan Xiong and Haoran Yang and Chengxiang Song and Wenhua Lei and Shiqin Peng and Yue Yin and Xuechen Qiao and Duolao Wang and Kim, \{Won Keun\} and \{De Backer\}, Ole and Mao Chen",

note = "Publisher Copyright: {\textcopyright} 2025 American College of Cardiology Foundation",

year = "2025",

month = jul,

day = "23",

doi = "10.1016/j.jcin.2025.05.045",

language = "English",

volume = "18",

pages = "1881--1892",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Inc.",

number = "15",

}

Li, W, Jia, Y, Li, H, Kobari, Y, Li, J, Feng, Y, Peng, Y, Wei, J, Zhao, Z, Xiong, T, Yang, H, Song, C, Lei, W, Peng, S, Yin, Y, Qiao, X, Wang, D, Kim, WK, De Backer, O & Chen, M 2025, 'Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR', JACC: Cardiovascular Interventions, vol. 18, no. 15, pp. 1881-1892. https://doi.org/10.1016/j.jcin.2025.05.045

TY - JOUR

T1 - Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR

AU - Li, Weiya

AU - Jia, Yuheng

AU - Li, Hongde

AU - Kobari, Yusuke

AU - Li, Junli

AU - Feng, Yuan

AU - Peng, Yong

AU - Wei, Jiafu

AU - Zhao, Zhengang

AU - Xiong, Tianyuan

AU - Yang, Haoran

AU - Song, Chengxiang

AU - Lei, Wenhua

AU - Peng, Shiqin

AU - Yin, Yue

AU - Qiao, Xuechen

AU - Wang, Duolao

AU - Kim, Won Keun

AU - De Backer, Ole

AU - Chen, Mao

PY - 2025/7/23

Y1 - 2025/7/23

N2 - Background: Differences in long-term clinical outcomes following transcatheter aortic valve replacement (TAVR) in different anatomical subtypes of aortic valve stenosis (AS), specifically tricuspid aortic valves (TAV) and bicuspid aortic valves (BAV) of types 0 (BAV-0) and 1 (BAV-1), are not well understood. Objectives: The authors sought to report and compare the long-term clinical outcomes among patients with different anatomical subtypes of AS undergoing TAVR. Methods: We conducted an international retrospective cohort study involving patients who underwent TAVR for severe AS at 3 large, high-volume heart centers in China, Germany, and Denmark before October 2018. Five-year follow-up ended on October 30, 2023, and the primary endpoint was all-cause mortality. Results: A total of 2,553 AS patients (BAV-0: n = 134; BAV-1: n = 305; TAV: n = 2,114) who underwent TAVR more than 5 years ago were included. The mean age of this cohort was 79.9 ± 6.8 years, and the median Society of Thoracic Surgeons score was 3.6% [Q1-Q3: 2.4%-5.4%]. The median follow-up time was 3.24 years (Q1-Q3: 1.25-5.00 years). At 5 years, BAV-1 (adjusted HR: 2.38 [95% CI: 1.32-4.28]; P = 0.004) and TAV (adjusted HR: 3.02 [95% CI: 1.71-5.31]; P < 0.001) had a higher risk for all-cause mortality after TAVR compared with BAV-0. BAV patients who were treated with balloon-expandable valves had a higher long-term all-cause mortality (41.7% [28.5%-52.5%] vs 23.6% [17.9%-28.8%]; HR: 1.63 [95% CI: 1.05-2.51]; P = 0.028) compared with those with self-expanding valves. Conclusions: Among patients with severe AS undergoing TAVR, BAV-0 was associated with a better long-term prognosis compared with TAV and BAV-1.

AB - Background: Differences in long-term clinical outcomes following transcatheter aortic valve replacement (TAVR) in different anatomical subtypes of aortic valve stenosis (AS), specifically tricuspid aortic valves (TAV) and bicuspid aortic valves (BAV) of types 0 (BAV-0) and 1 (BAV-1), are not well understood. Objectives: The authors sought to report and compare the long-term clinical outcomes among patients with different anatomical subtypes of AS undergoing TAVR. Methods: We conducted an international retrospective cohort study involving patients who underwent TAVR for severe AS at 3 large, high-volume heart centers in China, Germany, and Denmark before October 2018. Five-year follow-up ended on October 30, 2023, and the primary endpoint was all-cause mortality. Results: A total of 2,553 AS patients (BAV-0: n = 134; BAV-1: n = 305; TAV: n = 2,114) who underwent TAVR more than 5 years ago were included. The mean age of this cohort was 79.9 ± 6.8 years, and the median Society of Thoracic Surgeons score was 3.6% [Q1-Q3: 2.4%-5.4%]. The median follow-up time was 3.24 years (Q1-Q3: 1.25-5.00 years). At 5 years, BAV-1 (adjusted HR: 2.38 [95% CI: 1.32-4.28]; P = 0.004) and TAV (adjusted HR: 3.02 [95% CI: 1.71-5.31]; P < 0.001) had a higher risk for all-cause mortality after TAVR compared with BAV-0. BAV patients who were treated with balloon-expandable valves had a higher long-term all-cause mortality (41.7% [28.5%-52.5%] vs 23.6% [17.9%-28.8%]; HR: 1.63 [95% CI: 1.05-2.51]; P = 0.028) compared with those with self-expanding valves. Conclusions: Among patients with severe AS undergoing TAVR, BAV-0 was associated with a better long-term prognosis compared with TAV and BAV-1.

KW - all-cause mortality

KW - aortic valve stenosis

KW - bicuspid aortic valve

KW - transcatheter tricuspid valve replacement

U2 - 10.1016/j.jcin.2025.05.045

DO - 10.1016/j.jcin.2025.05.045

M3 - Article

AN - SCOPUS:105011984751

SN - 1936-8798

VL - 18

SP - 1881

EP - 1892

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

IS - 15

ER -

Long-Term Outcomes of BAV-0 Patients Compared With BAV-1 and TAV Patients After TAVR

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