Surgical vs. trans-catheter aortic valve replacement in patients With bicuspid aortic valve stenosis - Report - MDSpire
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Comparative Outcomes of Surgical and Transcatheter Aortic Valve Replacement in Patients with Bicuspid Aortic Valve Stenosis

  • By

  • Kobi Faierstein

  • Tal Caller

  • Dassi Moshkovitz

  • Efrat Sharon

  • Roy Raphael

  • Ido Cohen

  • Noam Makmal

  • Efrat Mazoe Dray

  • Afek Ash

  • Elad Maor

  • Ehud Regev

  • Amit Segev

  • Israel M. Barbash

  • Paul Fefer

  • June 25, 2026

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Comparative Outcomes of Surgical and Transcatheter Aortic Valve Replacement in Patients with Bicuspid Aortic Valve Stenosis

Overview

This study compares outcomes of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in patients with bicuspid aortic valve (BAV) stenosis.

Background

Bicuspid aortic valve (BAV) is a common congenital defect leading to aortic stenosis, often requiring valve replacement. The choice between TAVI and SAVR is critical, especially given the unique anatomical challenges posed by BAV. Understanding the comparative outcomes of these interventions is essential for optimizing patient care.

Data Highlights

OutcomeTAVISAVR
Mortality2844
Pacemaker Implantation19%4%
Paravalvular LeakHigherLower
Heart Failure HospitalizationsHigherLower

Key Findings

  • TAVI was associated with higher mortality compared to SAVR (adjusted HR = 5.9).
  • Higher rates of pacemaker implantation were observed in the TAVI group (19% vs. 4%).
  • TAVI resulted in more paravalvular leak complications (adjusted OR = 5.8).
  • Heart failure hospitalizations were significantly higher in the TAVI group (IRR=7.7).
  • Stroke rates were similar between TAVI and SAVR.

Clinical Implications

Clinicians should consider the comparative outcomes of TAVI and SAVR when discussing treatment options with patients.

Conclusion

In patients with BAV stenosis, further randomized trials are needed to determine the optimal treatment approach.

Related Resources & Content

  1. Clinical Research in Cardiology, 2020 -- Aortic Valve Replacement: Comparing Transcatheter and Surgical Approaches in Bicuspid Aortic Valve Patients
  2. Clinical Research in Cardiology, 2025 -- Comparative Long-Term Outcomes of TAVI with PCI versus SAVR with CABG: Insights from a Multicenter Registry
  3. Clinical Research in Cardiology, 2023 -- Outcomes of Valve-in-Valve Transcatheter Aortic Valve Implantation in Stentless Versus Stented Bioprosthetic Aortic Valves as Defined by VARC-3
  4. Clinical Research in Cardiology, 2022 -- Dysfunction and Failure of Bioprosthetic Valves Following TAVI in Patients with Bicuspid Aortic Valve Stenosis: A One-Year Follow-Up Analysis Based on VARC-3 Criteria
  5. Clinical Decision-Making in Aortic Stenosis in Patients With Bicuspid Valves - American College of Cardiology
  6. Comparison of short- and long-term outcomes between transcatheter and surgical aortic valve replacement for bicuspid aortic valve stenosis: a systematic review and meta-analysis - PubMed
  7. https://yjxzhi.files.cmp.optimizely.com/download/f718bde6bfbc11f08f5ddabefdf356e7
  8. Comparative outcomes of transcatheter aortic valve replacement in bicuspid vs. tricuspid aortic valve stenosis patients: insights from the SWEDEHEART registry
  9. Transcatheter Aortic Valve Implantation: Durability and Management of Valve Failure - American College of Cardiology
  10. TAVR Found Non-Inferior to SAVR for Low-Risk Patients - American College of Cardiology

Original Source(s)

Surgical vs. trans-catheter aortic valve replacement in patients With bicuspid aortic valve stenosis

  • by Kobi Faierstein, Tal Caller, Dassi Moshkovitz, Efrat Sharon, Roy Raphael, Ido Cohen, Noam Makmal, Efrat Mazoe Dray, Afek Ash, Elad Maor, Ehud Regev, Amit Segev, Israel M. Barbash, Paul Fefer

  • June 25, 2026

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