Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis

Yuheng Jia; Annette Maznyczka; Mauro Boiago; Arif Khokhar; Daijiro Tomii; Antoinette Neylon; Pauline Danthine; Thomas Levesque; Paul Bamford; Stefan Toggweiler; Federico Moccetti; Jarkko Piuhola; Marianna Adamo; Mauro Massussi; Alfonso Ielasi; Matteo Montorfano; Giulia Costa; Martin Swaans; Daniël C. Overduin; Clément Servoz; Caterina Gandolfo; Ingibjörg Jóna Guðmundsdóttir; Stefano Salizzoni; Joanna J. Wykrzykowska; Kees H. van Bergeijk; Andrea Buono; Tau Hartikainen; Stephane Noble; Darren Mylotte; Stephen Brecker; Ahmed Thabit; Antonio Mangieri; Pierfrancesco Agostoni; Matjaž Bunc; Maarten Vanhaverbeke; Johan Bosmans; Hélène Eltchaninoff; Azeem Latib; Daniel Blackman; Nicolas M. Van Mieghem; Yuan Feng; Won Keun Kim; Thomas Pilgrim; Bernard Prendergast; Didier Tchétché; Mao Chen; Ole De Backer

doi:10.1002/ccd.31742

Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis

Yuheng Jia, Annette Maznyczka, Mauro Boiago, Arif Khokhar, Daijiro Tomii, Antoinette Neylon, Pauline Danthine, Thomas Levesque, Paul Bamford, Stefan Toggweiler, Federico Moccetti, Jarkko Piuhola, Marianna Adamo, Mauro Massussi, Alfonso Ielasi, Matteo Montorfano, Giulia Costa, Martin Swaans, Daniël C. Overduin, Clément ServozCaterina Gandolfo, Ingibjörg Jóna Guðmundsdóttir, Stefano Salizzoni, Joanna J. Wykrzykowska, Kees H. van Bergeijk, Andrea Buono, Tau Hartikainen, Stephane Noble, Darren Mylotte, Stephen Brecker, Ahmed Thabit, Antonio Mangieri, Pierfrancesco Agostoni, Matjaž Bunc, Maarten Vanhaverbeke, Johan Bosmans, Hélène Eltchaninoff, Azeem Latib, Daniel Blackman, Nicolas M. Van Mieghem, Yuan Feng, Won Keun Kim, Thomas Pilgrim, Bernard Prendergast, Didier Tchétché, Mao Chen, Ole De Backer^*

^*Corresponding author for this work

Cardiology

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Abstract

Background: Data concerning the long-term durability of transcatheter aortic valves (TAVs) in patients with bicuspid aortic stenosis (AS) are lacking. Aims: The study aims to report data on long-term valve durability following transcatheter aortic valve replacement (TAVR) in bicuspid AS. Methods: This multicentre registry included patients who underwent TAVR for bicuspid AS with at least 2-year echocardiographic follow-up. The incidence of structural valve deterioration (SVD), bioprosthetic valve dysfunction (BVD), and bioprosthetic valve failure (BVF) was determined according to Valve Academic Research Consortium (VARC)-3 criteria. Results: Among 894 patients (mean age: 75.6 years; 39% female), the median echocardiographic follow-up was 48.7 months with a 5-year cumulative incidence of moderate-to-severe SVD, severe SVD, severe BVD, and BVF of 8.1%, 3.2%, 11.4%, and 6.1%, respectively. Younger age (≤ 75 years) was associated with a higher likelihood of reintervention (HR 2.40, log-rank p = 0.04). TAV downsizing was associated with higher rates of moderate-to-severe SVD (HR 3.05, log-rank p < 0.001), severe BVD (HR 2.07, log-rank p = 0.003), and BVF (HR 3.25, log-rank p = 0.002). In the sub-group with small annuli (area ≤ 430 mm²), implantation of balloon-expandable TAVs was associated with a higher rate of BVD in comparison with self-expanding TAVs (HR: 3.27, log-rank p = 0.008). Conclusions: TAVs demonstrated favorable 5-year durability in patients with bicuspid AS, although younger patients were more likely to require valve reintervention. Nominal TAV sizing was associated with better durability outcomes as compared to TAV downsizing. Self-expanding valves were associated with superior hemodynamics in patients with small annuli.

Original language	English
Pages (from-to)	1746-1757
Number of pages	12
Journal	Catheterization and Cardiovascular Interventions
Volume	106
Issue number	3
DOIs	https://doi.org/10.1002/ccd.31742
Publication status	Published - 1 Sept 2025

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© 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.

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Cathet Cardio Intervent - 2025 - Jia - Long‐Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid AorticFinal published version, 2.58 MBLicence: CC BY-NC

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Jia, Y., Maznyczka, A., Boiago, M., Khokhar, A., Tomii, D., Neylon, A., Danthine, P., Levesque, T., Bamford, P., Toggweiler, S., Moccetti, F., Piuhola, J., Adamo, M., Massussi, M., Ielasi, A., Montorfano, M., Costa, G., Swaans, M., Overduin, D. C., ... De Backer, O. (2025). Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis. Catheterization and Cardiovascular Interventions, 106(3), 1746-1757. https://doi.org/10.1002/ccd.31742

@article{429acd967e2f48bd9f0fa2f78727dedf,

title = "Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis",

abstract = "Background: Data concerning the long-term durability of transcatheter aortic valves (TAVs) in patients with bicuspid aortic stenosis (AS) are lacking. Aims: The study aims to report data on long-term valve durability following transcatheter aortic valve replacement (TAVR) in bicuspid AS. Methods: This multicentre registry included patients who underwent TAVR for bicuspid AS with at least 2-year echocardiographic follow-up. The incidence of structural valve deterioration (SVD), bioprosthetic valve dysfunction (BVD), and bioprosthetic valve failure (BVF) was determined according to Valve Academic Research Consortium (VARC)-3 criteria. Results: Among 894 patients (mean age: 75.6 years; 39\% female), the median echocardiographic follow-up was 48.7 months with a 5-year cumulative incidence of moderate-to-severe SVD, severe SVD, severe BVD, and BVF of 8.1\%, 3.2\%, 11.4\%, and 6.1\%, respectively. Younger age (≤ 75 years) was associated with a higher likelihood of reintervention (HR 2.40, log-rank p = 0.04). TAV downsizing was associated with higher rates of moderate-to-severe SVD (HR 3.05, log-rank p < 0.001), severe BVD (HR 2.07, log-rank p = 0.003), and BVF (HR 3.25, log-rank p = 0.002). In the sub-group with small annuli (area ≤ 430 mm2), implantation of balloon-expandable TAVs was associated with a higher rate of BVD in comparison with self-expanding TAVs (HR: 3.27, log-rank p = 0.008). Conclusions: TAVs demonstrated favorable 5-year durability in patients with bicuspid AS, although younger patients were more likely to require valve reintervention. Nominal TAV sizing was associated with better durability outcomes as compared to TAV downsizing. Self-expanding valves were associated with superior hemodynamics in patients with small annuli.",

author = "Yuheng Jia and Annette Maznyczka and Mauro Boiago and Arif Khokhar and Daijiro Tomii and Antoinette Neylon and Pauline Danthine and Thomas Levesque and Paul Bamford and Stefan Toggweiler and Federico Moccetti and Jarkko Piuhola and Marianna Adamo and Mauro Massussi and Alfonso Ielasi and Matteo Montorfano and Giulia Costa and Martin Swaans and Overduin, \{Dani{\"e}l C.\} and Cl{\'e}ment Servoz and Caterina Gandolfo and Gu{\dh}mundsd{\'o}ttir, \{Ingibj{\"o}rg J{\'o}na\} and Stefano Salizzoni and Wykrzykowska, \{Joanna J.\} and \{van Bergeijk\}, \{Kees H.\} and Andrea Buono and Tau Hartikainen and Stephane Noble and Darren Mylotte and Stephen Brecker and Ahmed Thabit and Antonio Mangieri and Pierfrancesco Agostoni and Matja{\v z} Bunc and Maarten Vanhaverbeke and Johan Bosmans and H{\'e}l{\`e}ne Eltchaninoff and Azeem Latib and Daniel Blackman and \{Van Mieghem\}, \{Nicolas M.\} and Yuan Feng and Kim, \{Won Keun\} and Thomas Pilgrim and Bernard Prendergast and Didier Tch{\'e}tch{\'e} and Mao Chen and \{De Backer\}, Ole",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.",

year = "2025",

month = sep,

day = "1",

doi = "10.1002/ccd.31742",

language = "English",

volume = "106",

pages = "1746--1757",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "John Wiley \& Sons Inc.",

number = "3",

}

Jia, Y, Maznyczka, A, Boiago, M, Khokhar, A, Tomii, D, Neylon, A, Danthine, P, Levesque, T, Bamford, P, Toggweiler, S, Moccetti, F, Piuhola, J, Adamo, M, Massussi, M, Ielasi, A, Montorfano, M, Costa, G, Swaans, M, Overduin, DC, Servoz, C, Gandolfo, C, Guðmundsdóttir, IJ, Salizzoni, S, Wykrzykowska, JJ, van Bergeijk, KH, Buono, A, Hartikainen, T, Noble, S, Mylotte, D, Brecker, S, Thabit, A, Mangieri, A, Agostoni, P, Bunc, M, Vanhaverbeke, M, Bosmans, J, Eltchaninoff, H, Latib, A, Blackman, D, Van Mieghem, NM, Feng, Y, Kim, WK, Pilgrim, T, Prendergast, B, Tchétché, D, Chen, M & De Backer, O 2025, 'Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis', Catheterization and Cardiovascular Interventions, vol. 106, no. 3, pp. 1746-1757. https://doi.org/10.1002/ccd.31742

TY - JOUR

T1 - Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis

AU - Jia, Yuheng

AU - Maznyczka, Annette

AU - Boiago, Mauro

AU - Khokhar, Arif

AU - Tomii, Daijiro

AU - Neylon, Antoinette

AU - Danthine, Pauline

AU - Levesque, Thomas

AU - Bamford, Paul

AU - Toggweiler, Stefan

AU - Moccetti, Federico

AU - Piuhola, Jarkko

AU - Adamo, Marianna

AU - Massussi, Mauro

AU - Ielasi, Alfonso

AU - Montorfano, Matteo

AU - Costa, Giulia

AU - Swaans, Martin

AU - Overduin, Daniël C.

AU - Servoz, Clément

AU - Gandolfo, Caterina

AU - Guðmundsdóttir, Ingibjörg Jóna

AU - Salizzoni, Stefano

AU - Wykrzykowska, Joanna J.

AU - van Bergeijk, Kees H.

AU - Buono, Andrea

AU - Hartikainen, Tau

AU - Noble, Stephane

AU - Mylotte, Darren

AU - Brecker, Stephen

AU - Thabit, Ahmed

AU - Mangieri, Antonio

AU - Agostoni, Pierfrancesco

AU - Bunc, Matjaž

AU - Vanhaverbeke, Maarten

AU - Bosmans, Johan

AU - Eltchaninoff, Hélène

AU - Latib, Azeem

AU - Blackman, Daniel

AU - Van Mieghem, Nicolas M.

AU - Feng, Yuan

AU - Kim, Won Keun

AU - Pilgrim, Thomas

AU - Prendergast, Bernard

AU - Tchétché, Didier

AU - Chen, Mao

AU - De Backer, Ole

PY - 2025/9/1

Y1 - 2025/9/1

N2 - Background: Data concerning the long-term durability of transcatheter aortic valves (TAVs) in patients with bicuspid aortic stenosis (AS) are lacking. Aims: The study aims to report data on long-term valve durability following transcatheter aortic valve replacement (TAVR) in bicuspid AS. Methods: This multicentre registry included patients who underwent TAVR for bicuspid AS with at least 2-year echocardiographic follow-up. The incidence of structural valve deterioration (SVD), bioprosthetic valve dysfunction (BVD), and bioprosthetic valve failure (BVF) was determined according to Valve Academic Research Consortium (VARC)-3 criteria. Results: Among 894 patients (mean age: 75.6 years; 39% female), the median echocardiographic follow-up was 48.7 months with a 5-year cumulative incidence of moderate-to-severe SVD, severe SVD, severe BVD, and BVF of 8.1%, 3.2%, 11.4%, and 6.1%, respectively. Younger age (≤ 75 years) was associated with a higher likelihood of reintervention (HR 2.40, log-rank p = 0.04). TAV downsizing was associated with higher rates of moderate-to-severe SVD (HR 3.05, log-rank p < 0.001), severe BVD (HR 2.07, log-rank p = 0.003), and BVF (HR 3.25, log-rank p = 0.002). In the sub-group with small annuli (area ≤ 430 mm2), implantation of balloon-expandable TAVs was associated with a higher rate of BVD in comparison with self-expanding TAVs (HR: 3.27, log-rank p = 0.008). Conclusions: TAVs demonstrated favorable 5-year durability in patients with bicuspid AS, although younger patients were more likely to require valve reintervention. Nominal TAV sizing was associated with better durability outcomes as compared to TAV downsizing. Self-expanding valves were associated with superior hemodynamics in patients with small annuli.

AB - Background: Data concerning the long-term durability of transcatheter aortic valves (TAVs) in patients with bicuspid aortic stenosis (AS) are lacking. Aims: The study aims to report data on long-term valve durability following transcatheter aortic valve replacement (TAVR) in bicuspid AS. Methods: This multicentre registry included patients who underwent TAVR for bicuspid AS with at least 2-year echocardiographic follow-up. The incidence of structural valve deterioration (SVD), bioprosthetic valve dysfunction (BVD), and bioprosthetic valve failure (BVF) was determined according to Valve Academic Research Consortium (VARC)-3 criteria. Results: Among 894 patients (mean age: 75.6 years; 39% female), the median echocardiographic follow-up was 48.7 months with a 5-year cumulative incidence of moderate-to-severe SVD, severe SVD, severe BVD, and BVF of 8.1%, 3.2%, 11.4%, and 6.1%, respectively. Younger age (≤ 75 years) was associated with a higher likelihood of reintervention (HR 2.40, log-rank p = 0.04). TAV downsizing was associated with higher rates of moderate-to-severe SVD (HR 3.05, log-rank p < 0.001), severe BVD (HR 2.07, log-rank p = 0.003), and BVF (HR 3.25, log-rank p = 0.002). In the sub-group with small annuli (area ≤ 430 mm2), implantation of balloon-expandable TAVs was associated with a higher rate of BVD in comparison with self-expanding TAVs (HR: 3.27, log-rank p = 0.008). Conclusions: TAVs demonstrated favorable 5-year durability in patients with bicuspid AS, although younger patients were more likely to require valve reintervention. Nominal TAV sizing was associated with better durability outcomes as compared to TAV downsizing. Self-expanding valves were associated with superior hemodynamics in patients with small annuli.

UR - https://www.scopus.com/pages/publications/105009867842

U2 - 10.1002/ccd.31742

DO - 10.1002/ccd.31742

M3 - Article

C2 - 40611498

AN - SCOPUS:105009867842

SN - 1522-1946

VL - 106

SP - 1746

EP - 1757

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 3

ER -

Long-Term Durability of Transcatheter Aortic Valves in Patients With Bicuspid Aortic Stenosis

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