Long-Term Outcomes of Contemporary Balloon-Expandable TAVR in Bicuspid Aortic Valve

BACKGROUND: Limited data are available comparing clinical outcomes between bicuspid and tricuspid patients following transcatheter aortic valve replacement (TAVR). OBJECTIVES: This study sought to investigate 5-year clinical outcomes in patients with severe aortic stenosis following TAVR with contemporary balloon-expandable valves (BEVs) in patients with bicuspid vs tricuspid leaflet morphology. METHODS: From August 2015 to December 2023, a total of 3,393 patients with native aortic stenosis who underwent TAVR with contemporary BEVs were divided into bicuspid and tricuspid groups. A 1:1 propensity score-matched analysis was performed to adjust for baseline differences. The primary endpoint was all-cause mortality at 5-year follow-up. RESULTS: , P = 0.084), and moderate or greater paravalvular leak (3.9% vs 5.6%; P = 0.578) did not differ significantly between groups. CONCLUSIONS: In propensity score-matched patients undergoing TAVR with contemporary BEVs, long-term clinical outcomes, valve performance, and ascending aortic growth rate showed no statistically significant differences between bicuspid and tricuspid groups.