Featured Research

from universities, journals, and other organizations

TAVI feasible in bicuspid aortic valve, study suggests

Date:
September 2, 2013
Source:
European Society of Cardiology
Summary:
Transcatheter aortic valve implantation (TAVI) is feasible in patients with bicuspid aortic valve, according to new research. The findings open up a new treatment possibility in patients with BV, which has been considered a contraindication for TAVI.

Bicuspid aortic valve (BV) is the most common congenital valvular abnormality, occurring in 1-2% of the general population. Two of the aortic valvular leaflets fuse during development resulting in a valve that is bicuspid instead of the normal tricuspid configuration. BV is associated with increased mechanical stress which predisposes to calcification and development of aortic stenosis which narrows the opening of the aortic valve.

Dr Bauer said: "TAVI is used to treat elderly high risk patients with severe aortic stenosis. Despite previous assumptions the frequency of BV is quite high even among elderly patients with symptomatic aortic stenosis."

But he added: "BV has been considered a relative contraindication to TAVI. One of the main reasons is the presumed risk for relevant aortic regurgitation, where blood leaks back through the aortic valve during ventricular diastole. However, case reports and small case series have suggested that TAVI can be successfully performed with acceptable clinical outcomes in high risk patients with BV."

The study prospectively enrolled 1,424 patients with severe aortic stenosis undergoing TAVI into the German TAVI-Registry between January 2009 and June 2010. For the present analysis patients with valve-in-valve procedures were excluded and those with BV (n=38, 2.7%) were compared to those with tricuspid aortic valve (TV) (n=1,357, 97.3%). Patient characteristics did not markedly differ and procedural success was very high in both groups.

The researchers found a higher rate of relevant aortic regurgitation (≥ grade 2) after TAVI among patients with BV (BV=25%, TV=14.7%; p=0.05), whereas pacemakers were more often implanted in patients with TV (BV=16.7%, TV=35.4%; p=0.02). Dr Bauer said: "The higher rate of aortic regurgitation in BV patients was expected and is still acceptable because it did not lead to higher mortality. However, substantial improvements in the field of device technology and imaging have to be made to perform TAVI in a safer and more effective way in BV-patients."

He added: "The difference between groups in the need for a pacemaker can be partly explained by the higher implantation rate of Sapien EdwardsTM prosthesis. Maybe anatomic differences in the aortic root or left ventricular outflow tract of BV play a role, too."

The 30-day mortality was similar in both cohorts (BV=10.5%, TV=10.8%). In a Cox proportional regression analysis after adjustment for several risk factors BV was not associated with higher 1-year mortality (hazard ratio [HR]=0.64, 95% confidence interval [CI]=0.29-1.41). Dr Bauer said: "Both 30-day and 1-year mortality were not elevated in BV patients compared to patients with TV. We can therefore conclude that TAVI gave a satisfactory clinical outcome in BV patients despite their higher rate of relevant aortic regurgitation."

He concluded: "As the nature of our study is exploratory and the number of BV patients is quite low, the findings should be interpreted cautiously. However, our study opens up a new treatment possibility for selected high risk patients with BV, who until now have received medical treatment only or conventional valve surgery. TAVI has the potential to be a safe alternative in these patients, but more studies are needed to support these findings."


Story Source:

The above story is based on materials provided by European Society of Cardiology. Note: Materials may be edited for content and length.


Cite This Page:

European Society of Cardiology. "TAVI feasible in bicuspid aortic valve, study suggests." ScienceDaily. ScienceDaily, 2 September 2013. <www.sciencedaily.com/releases/2013/09/130902101900.htm>.
European Society of Cardiology. (2013, September 2). TAVI feasible in bicuspid aortic valve, study suggests. ScienceDaily. Retrieved August 22, 2014 from www.sciencedaily.com/releases/2013/09/130902101900.htm
European Society of Cardiology. "TAVI feasible in bicuspid aortic valve, study suggests." ScienceDaily. www.sciencedaily.com/releases/2013/09/130902101900.htm (accessed August 22, 2014).

Share This




More Health & Medicine News

Friday, August 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Two US Ebola Patients Leave Hospital Free of the Disease

Two US Ebola Patients Leave Hospital Free of the Disease

AFP (Aug. 21, 2014) Two American missionaries who were sickened with Ebola while working in Liberia and were treated with an experimental drug are doing better and have left the hospital, doctors say on August 21, 2014. Duration: 01:05 Video provided by AFP
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins