Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis
The clinical use indications for transcatheter aortic valve replacement (TAVR) for the treatment of severe symptomatic aortic stenosis (AS) have expanded from patients at high surgical risk to those at low risk based on the results of multiple large-scale randomized trials. However, patients with...
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| Format: | Article |
| Language: | English |
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IMR Press
2021-12-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://rcm.imrpress.com/EN/10.31083/j.rcm2204124 |
| _version_ | 1819106057423683584 |
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| author | Jian-Di Liu Xian-Du Luo Zhi-Peng Zhou Ren Gong Yan-Qing Wu |
| author_facet | Jian-Di Liu Xian-Du Luo Zhi-Peng Zhou Ren Gong Yan-Qing Wu |
| author_sort | Jian-Di Liu |
| collection | DOAJ |
| description | The clinical use indications for transcatheter aortic valve replacement (TAVR)
for the treatment of severe symptomatic aortic stenosis (AS) have expanded from
patients at high surgical risk to those at low risk based on the results of
multiple large-scale randomized trials. However, patients with bicuspid AS have
traditionally been excluded from clinical trials due to their unfavorable
morphological characteristics. Bicuspid aortic valve (BAV) is the most frequent
congenital heart disease, occurring in 1% to 2% of the total population and
affects more than 20% of octogenarians undergoing isolated aortic valve
replacement for AS. In recent years, TAVR in patients with bicuspid AS has been
the focus of research, especially with respect to the standard of prosthesis size
selection. Annulus-based prosthesis size selection using computed tomography (CT)
is the standard sizing strategy for tricuspid AS, but no standard sizing for
bicuspid AS has been developed thus far. According to Western TAVR experiences,
transcatheter heart valve (THV) size selection for BAV patients should be based
on the annular structure assessment by CT measurement, whereas Chinese
experiences favor adopting the supra-annulus structure assessment for THV size
selection. This article will review annular and supra-annular sizing for
prosthesis size selection in patients with bicuspid AS before TAVR and discuss
which has more favorable clinical outcomes. |
| first_indexed | 2024-12-22T02:32:05Z |
| format | Article |
| id | doaj.art-6389b63aa1794786a1a6c844083727e7 |
| institution | Directory Open Access Journal |
| issn | 2153-8174 |
| language | English |
| last_indexed | 2024-12-22T02:32:05Z |
| publishDate | 2021-12-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-6389b63aa1794786a1a6c844083727e72022-12-21T18:41:52ZengIMR PressReviews in Cardiovascular Medicine2153-81742021-12-012241157116610.31083/j.rcm2204124S1530-6550(21)00244-1Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosisJian-Di Liu0Xian-Du Luo1Zhi-Peng Zhou2Ren Gong3Yan-Qing Wu4Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, ChinaThe clinical use indications for transcatheter aortic valve replacement (TAVR) for the treatment of severe symptomatic aortic stenosis (AS) have expanded from patients at high surgical risk to those at low risk based on the results of multiple large-scale randomized trials. However, patients with bicuspid AS have traditionally been excluded from clinical trials due to their unfavorable morphological characteristics. Bicuspid aortic valve (BAV) is the most frequent congenital heart disease, occurring in 1% to 2% of the total population and affects more than 20% of octogenarians undergoing isolated aortic valve replacement for AS. In recent years, TAVR in patients with bicuspid AS has been the focus of research, especially with respect to the standard of prosthesis size selection. Annulus-based prosthesis size selection using computed tomography (CT) is the standard sizing strategy for tricuspid AS, but no standard sizing for bicuspid AS has been developed thus far. According to Western TAVR experiences, transcatheter heart valve (THV) size selection for BAV patients should be based on the annular structure assessment by CT measurement, whereas Chinese experiences favor adopting the supra-annulus structure assessment for THV size selection. This article will review annular and supra-annular sizing for prosthesis size selection in patients with bicuspid AS before TAVR and discuss which has more favorable clinical outcomes.https://rcm.imrpress.com/EN/10.31083/j.rcm2204124transcatheter aortic valve replacement (tavr)aortic stenosis (as)bicuspid aortic valve (bav)prosthesis size selection |
| spellingShingle | Jian-Di Liu Xian-Du Luo Zhi-Peng Zhou Ren Gong Yan-Qing Wu Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis Reviews in Cardiovascular Medicine transcatheter aortic valve replacement (tavr) aortic stenosis (as) bicuspid aortic valve (bav) prosthesis size selection |
| title | Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis |
| title_full | Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis |
| title_fullStr | Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis |
| title_full_unstemmed | Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis |
| title_short | Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis |
| title_sort | annular and supra annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis |
| topic | transcatheter aortic valve replacement (tavr) aortic stenosis (as) bicuspid aortic valve (bav) prosthesis size selection |
| url | https://rcm.imrpress.com/EN/10.31083/j.rcm2204124 |
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