Elliptical shape of a SAPIEN XT prosthesis deployed in a patient with bicuspid aortic valve stenosis.

Transcatheter aortic valve implantation (TAVI) has been shown as an effective procedure in patients considered at high risk for surgery. Aortic valve bicuspidy, as encountered in up of 50% of patients with severe aortic stenosis, has been considered a contraindication to TAVI. One reason for this is that stent deformation is likely to occur after prosthesis deployment, but this has been refuted by recent observations with the SAPIEN prosthesis. Herein is reported the first case of a severely deformed SAPIEN XT prosthesis after TAVI in a patient with severe symptomatic aortic stenosis, and known to have a bicuspid native aortic valve.