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
N1 - Publisher Copyright:
© 2025 American College of Cardiology Foundation
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 -