TAVR for Bicuspid Aortic Valve

Bicuspid aortic valve ( BAV ) is the most common congenital heart valve abnormality. Different BAV phenotypes determine procedural and clinical success with transcatheter aortic valve replacement ( TAVR ). BAV has consistently been an exclusion criterium in the pivotal randomized controlled TAVR trials. Patients with BAVs are typically younger and at lower surgical risk. Registry data confirmed favorable clinical outcome after TAVR with contemporary THV platforms in selected cohorts of BAV patients. Still, TAVR in the context of BAV seems associated with a higher rate of stroke and more than mild paravalvular leakage. Optimized patient selection and continued THV iterations may further improve TAVR outcomes in BAV.