Global variability in bicuspid aortic valve morphology and aortopathy among patients with severe aortic stenosis referred for transcatheter valve implantation

BACKGROUND: While some studies have investigated the characteristics of patients from Asian versus European regions with bicuspid aortic valve (BAV) disease undergoing transcatheter aortic valve implantation (TAVI), geographic differences in a worldwide population remain poorly understood. The aim of our study was to evaluate the geographic differences of aortic valve morphology, annular size and associated aortopathy in a large, diverse population of India, West Europe, East Europe, Latin America, Middle East, Russia Commonwealth of Independent States, Asia Pacific and Africa patients with severe aortic stenosis (AS) referred for TAVI. METHODS: Data from cardiovascular multislice CT of severe AS patients referred for TAVI were analysed in a centralised core laboratory. Differences in valvular phenotype, annular size and aortic morphology were analysed with a focus on BAV patients. RESULTS: Among 12 712 patients evaluated, 3203 (25%) had BAV. These patients were more frequently male, younger and had larger annular area, aortic root diameters and higher prevalence of horizontal aorta (23% vs 10%, p