Expert Consensus on Sizing and Positioning of SAPIEN 3/Ultra in Bicuspid Aortic Valves

Overview

Journal Cardiol Ther

Specialty Cardiology & Vascular Diseases

Date 2021 Jun 3

PMID 34081277

Citations 5

Authors

Daniel Blackman

Davide Gabbieri

Bruno Garcia Del Blanco

Jorg Kempfert

Mika Laine

Julia Mascherbauer

Radoslaw Parma

Didier Tchetche

Affiliations

Soon will be listed here.

Abstract

Severe aortic stenosis patients with bicuspid anatomy have been excluded from the major transcatheter aortic valve replacement (TAVI) randomized clinical trials. As a result, there is no official recommendation on bicuspid TAVI. A panel of bicuspid experts was created to fill this gap. In this consensus statement, an algorithm is proposed to guide the choice of surgery or TAVI within this complex patient population, depending on aortic dilatation, age, surgical risk score, and anatomy. A step-by-step guide for sizing and positioning of the SAPIEN 3/Ultra TAVI bioprostheses is presented. Annular sizing remains the primary strategy in most bicuspid patients. However, some anatomies may require sizing at the supra-annular level, for which patients the panel recommends the circle method, a dedicated sizing and positioning approach for SAPIEN 3/Ultra. The consensus provides valuable pre-operative insights on the interactions between SAPIEN 3/Ultra and the bicuspid anatomy; understanding the valve-anatomy relationship is critical to avoid complications and to optimize outcomes for patients.

Citing Articles

Transcatheter Aortic Valve Implantation (TAVI) in Bicuspid Anatomy.

Nikas D, Lakkas L, Naka K, Michalis L J Clin Med. 2025; 14(3).

PMID: 39941442 PMC: 11818256. DOI: 10.3390/jcm14030772.

Transcatheter Aortic Valve Implantation for Bicuspid Aortic Valve Disease: Procedural Planning and Clinical Outcomes.

Gutierrez L, Boiago M, De Biase C, Oliva O, Laforgia P, Feliachi S J Clin Med. 2023; 12(22).

PMID: 38002687 PMC: 10672483. DOI: 10.3390/jcm12227074.

Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis.

Dayawansa N, Noaman S, Teng L, Htun N J Cardiovasc Dev Dis. 2023; 10(10).

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Results of new-generation balloon vs. self-expandable transcatheter heart valves for bicuspid aortic valve stenosis.

Deutsch O, Vitanova K, Ruge H, Erlebach M, Krane M, Lange R Front Cardiovasc Med. 2023; 10:1252163.

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TAVI in younger patients with bicuspid aortic stenosis: pros and cons.

Blackman D, Ali N, Borger M EuroIntervention. 2022; 18(10):790-792.

PMID: 36412140 PMC: 9725078. DOI: 10.4244/EIJ-E-22-00042.

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