Transcatheter aortic valve intervention in mixed Sievers type 1 bicuspid aortic valve disease.
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Zito Andrea, Galasso Michele, Kim Won-Keun, Scotti Andrea, Fabris Tommaso, Arturi Federico, de Biase Chiara, Bellamoli Michele, Montarello Nicholas, Costa Giuliano, Alfadhel Mesfer, Koren Ofir, Bellini Barbara, Massussi Mauro, Angelillis Marco, Giacomin Enrico, Gorla Riccardo, Hug Karsten, Briguori Carlo, Bettari Luca, Romagnoli Enrico, Orbach Ady, De Carlo Marco, Renker Matthias, García Gómez Mario, Trani Carlo, Ielasi Alfonso, Landes Uri, Rheude Tobias, Bedogni Francesco, Amat-Santos Ignacio J, Mangieri Antonio, Gitto Mauro, Saia Francesco, Favero Luca, Chen Mao, Adamo Marianna, Petronio Anna Sonia, Montorfano Matteo, Makkar Raj R, Mylotte Darren, Blackman Daniel J, Barbanti Marco, De Backer Ole, Tchètchè Didier, Tarantini Giuseppe, Latib Azeem, Maffeo Diego, Burzotta Francesco, Buono Andrea
Аннотация
METHODS: We enrolled consecutive patients with severe Sievers type 1 BAV stenosis undergoing TAVI at 24 international centers. Patients were stratified into 2 groups according to baseline AR severity: pure BAV stenosis (ie, no or mild AR) and mixed BAV disease (ie, moderate or severe AR). Clinical outcomes were compared using adjusted Cox models. The primary endpoint was major adverse events (MAE), defined as a composite of all-cause death, cerebrovascular events, or hospitalization for heart failure.
RESULTS: A total of 956 patients were included, of whom 134 (14%) had mixed BAV disease and 822 (86%) had pure BAV stenosis. At a median follow-up of 1.2 [0.4-2.2] years, patients with mixed BAV disease had a lower risk of MAE compared with those with pure BAV stenosis (9.0% vs 17.5%; adjusted hazard ratio [HRadj], 0.47; 95%CI, 0.25-0.85; P=.013), mainly driven by a significantly lower risk of all-cause death (6.0% vs 12.0%; HRadj, 0.44; 95%CI, 0.21-0.92; P=.029).
CONCLUSIONS: Among patients with Sievers type 1 BAV stenosis undergoing TAVI, those with mixed BAV disease had a lower risk of MAE than those with pure BAV stenosis.