Changes in the Severity of Mitral Regurgitation After Transcatheter Aortic Valve Implantation in Patients With Severe Bicuspid Aortic Stenosis

Bicuspid aortic valve (BAV) is the most common congenital cardiac anomaly and the need for aortic valve (AV) intervention is common in these patients because of altered structural and geometric changes leading to altered blood flow across the valve. 1 Mahadevia R Barker A Schnell S Entezari P Kansal P Fedak P Malaisrie S McCarthy P Collins J Carr J Markl M. Bicuspid aortic cusp fusion morphology alters aortic three-dimensional outflow patterns, wall shear stress, and expression of aortopathy. Circulation. 2014; 129: 673-682 Google Scholar Concurrent mitral regurgitation (MR) with bicuspid aortic stenosis (AS) is common and leads to a complex interplay between hemodynamic conditions and loading conditions on the ventricle. 2 Witberg G Codner P Landes U Schwartzenberg S Barbanti M Valvo R De Backer O Ooms JF Islas F Marroquin L Sedaghat A Sugiura A Masiero G Werner P Armario X Fiorina C Arzamendi D Santos-Martinez S Fernández-Vázquez F Baz J Steblovnik K Mauri V Adam M Merdler I Hein M Ruile P Grasso C Branca L Estévez-Loureiro R Benito-González T Amat-Santos I Mylotte D Andreas M Bunc M Tarantini G Sinning J Nombela-Franco L Søndergaard L Van Mieghem N Finkelstein A Kornowski R. Effect of transcatheter aortic valve replacement on concomitant mitral regurgitation and its impact on mortality. JACC Cardiovasc Interv. 2021; 14: 1181-1192 Google Scholar Transcatheter AV implantation (TAVI) is associated with improvement of MR in >50% of patients with the degree of residual MR after TAVI associated with higher mortality. 3 Cortés C Amat-Santos I Nombela-Franco L Muñoz-Garcia A Gutiérrez-Ibanes E De La Torre Hernandez J Córdoba-Soriano J Jimenez-Quevedo P Hernández-García J Gonzalez-Mansilla A Ruano J Jimenez-Mazuecos J Castrodeza J Tobar J Islas F Revilla A Puri R Puerto A Gómez I Rodés-Cabau J San Román JA Mitral regurgitation after transcatheter aortic valve replacement: prognosis, imaging predictors, and potential management. JACC Cardiovasc Interv. 2016; 9: 1603-1614 Google Scholar Although data exists on the changes in MR after TAVI, there is no dedicated data in bicuspid AS. Our study aimed to evaluate the changes in MR severity after TAVI in bicuspid AS.