Evaluation on short-term efficacy and safety of transcatheter aortic valve replacement for patients with severe stenosis of bicuspid aortic valve

  Objective  To evaluate the short-term efficacy and safety of transcatheter aortic valve replacement (TAVR)in patients with severe stenosis of bicuspid aortic valve.

  Methods  A total of 8 patients diagnosed with severe aortic valve stenosis in our hospital were selected and underwent TAVR. All patients were followed up for three months, the basic data, intraoperative complications, and postoperative echocardiography were compared. The mortality rate, serious vascular complications, serious bleeding and other adverse events were observed.

  Results  All the 8 patients were diagnosed as severe bicuspid aortic valve stenosis, and were performed TAVR successfully. All the eight patients, aged(77.4±8.2)years averagely, were complicated with impaired heart function (NYHA Ⅲ-Ⅳ), with a (8.9±5.2) % of mean mortality scores of Society of Thoracic Surgery (STS) and a (28.3±22.5) % of mean European Heart Surgery Risk Regression Score. Among them, 1 patient received permanent pacemaker implantation after surgery, and l patient received valve-in-valve implantation technique. No acute coronary artery occlusion occurred in all patients. After 3 months follow-up, no death was found, only 1 case occurred mild gastrointestinal bleeding, but no serious vascular complications. The mean aortic valve pressure gradient decreased significantly right after surgery and three months after surgery (P < 0.05). The left ventricular ejection fraction (LVEF) increased significantly compared to the surgery before(P < 0.05).

  Conclusion  TAVR can effectively reduce the mean aortic valve pressure difference and improve cardiac function in patients with severe bicuspid aortic valve stenosis.