Home > Riviste > Minerva Cardioangiologica > Fascicoli precedenti > Minerva Cardioangiologica 2018 April;66(2) > Minerva Cardioangiologica 2018 April;66(2):129-35



Publication history
Per citare questo articolo


Rivista sulle Malattie del Cuore e dei Vasi

Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,695




Minerva Cardioangiologica 2018 April;66(2):129-35

DOI: 10.23736/S0026-4725.17.04531-5


lingua: Inglese

Transcatheter aortic valve implantation in bicuspid anatomy: procedural results with two different types of valves

Patrizia PRESBITERO 1 , Loredana IANNETTA 1, Paolo PAGNOTTA 1, Bernhard REIMERS 1, Marco L. ROSSI 1, Dennis ZAVALLONI PARENTI 1, Giovanni BIANCHI 2, Francesco BEDOGNI 2

1 Humanitas Research Hospital, Rozzano, Milan, Italy; 2 Policlinico San Donato, Milan, Italy


BACKGROUND: It is well known that bicuspid valve stenosis can be treated with transcatheter aortic valve implantation (TAVI) even if specific issues can cause problems: dilatation of ascending aorta, possible aorthopathy, eccentricity of the valve and calcium distribution in leaflets and in commissures. We classified Bicuspid aortic valve (BAV) in type 0 (2 cusps and no raphe), and type 1 (2 cusps and one or more raphes). The aim of the present study was to report the results of two types of valve (CoreValve from 2009 to 2016 and Lotus valve from 2014 to 2017) in a consecutive series of BAV patients treated in 2 Italian centers.
METHODS: A total of 30 patients with BAV underwent TAVI from September 2009 to March 2017.
RESULTS: Mean age was 78±8 years, 54.5% were males and 7.4% had peripheral vasculopathy, 6.5% previous stroke or TIA, 15.6% previous PCI and 9.4% previous coronary artery bypass grafting. Ten patients (30.3%) had a type 1; mean aortic valvular gradient was 57.7±17.7 mmHg; aortic valvular area was 0.7±0.2 mm2, left ventricular ejection fraction was 51.4±10.0% and ascending aorta was 41.0±5.6 mm. Among these 30 patients, 16 of them (group 1) undergone CoreValve implantation and 14 (group 2) undergone Lotus valve implantation. Patients in the first group had a higher Logistic Euroscore (P<0.001) and higher AVA (P=0.026) and valve area CT (P=0.003). Device size in group1 was more often bigger than in group 2 (P<0.001) and postdilatation was never used in the last group. Group 1 had a significant more frequent aortic regurgitation ≥2 assessed with angiography (28.6% vs. 0%; P=0.05). A non-statistically significant higher rate of second valve implantation (6.2% vs. 0%; P=1.00) was also observed. New permanent pacemaker implantation (40.0% vs. 35.7%; P=0.812) was equal in both valves.
CONCLUSIONS: Postprocedural aortic regurgitation is still an issue in BAV undergone TAVI when: 1) the annulus is big; 2) when we are using self-expandable valves; and 3) in type 0 valves. Lotus valve, with a higher radial force put in a small annuls seems associated to better procedural outcomes in this subset of patients.

KEY WORDS: Bicuspid aortic valve - Aortic valve stenosis - Transcatheter aortic valve implantation

inizio pagina

Publication History

Issue published online: March 5, 2018
Manuscript accepted: October 24, 2017
Manuscript received: September 30, 2017

Per citare questo articolo

Presbitero P, Iannetta L, Pagnotta P, Reimers B, Rossi ML, Zavalloni Parenti D, et al. Transcatheter aortic valve implantation in bicuspid anatomy: procedural results with two different types of valves. Minerva Cardioangiol 2018;66:129-35. DOI: 10.23736/S0026-4725.17.04531-5

Corresponding author e-mail