Transcatheter aortic valve implantation (TAVI) is being offered to younger patients affected by severe aortic stenosis as an alternative to surgery. Although historically excluded from the main randomized clinical trials, patients with native bicuspid aortic valve (BAV) are commonly treated in daily TAVI practice. Indeed, several observational studies reported similar outcomes of TAVI in BAV patients compared to tricuspid aortic valve (TAV) patients. Notably, BAV is frequently associated with aortic dilatation (20% to 84% of BAV patients). Surgical patients usually undergo concomitant aortic root replacement if aortic diameter exceed 50 mm (5). TAVI patients do not undergo treatment of the concomitant aortopathy, but currently there is a paucity of data regarding the progression of the aortopathy after AS treatment (6,7). The main aim of this ambispective, multicenter study is to evaluate the progression of the bicuspid valve-associated aortopathy in patients undergoing TAVI by computed tomography angiography (CTA) assessment at follow-up.
Study Type
OBSERVATIONAL
Enrollment
300
Computed tomography angiography assessment of BAV-related aorthopathy
AOU Policlinico G. Rodolico - San Marco
Catania, Italy
Absolute difference in maximum aortic diameters at multiple levels of ascending aorta
Measurements of maximum aortic diameters at follow-up CTA assessment will be compared with values at pre-TAVI CTA assessment
Time frame: 5 years
Death, stroke or rehospitalization for heart failure
Death, stroke or rehospitalization for heart failure
Time frame: 5 years
Aortic events leading to urgent intervention or elective aortic root replacement
Aortic events (i.e. fissuration, dissection) after the index intervention leading to aortic intervention, or elective aortic root replacement.
Time frame: 5 years
Bioprosthesis dysfunction (HALT or RLM at 4-D CTA assessment)
Presence of hypo-attenuated leaflet thickening (HALT)/reduced leaflet motion (RLM) at follow-up four-dimensional CTA assessment
Time frame: 5 years
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