Medtronic Evolut R transcatheter aortic heart valve [Image from Medtronic]
A recent study has shown that transcatheter aortic valve replacement (TAVR) is a safe treatment option for people who need a bicuspid aortic valve replacement.
The study found that patients who were at an increased risk for surgery had a 30-day and one-year mortality rate and stroke rate similar to patients with more common tricuspid valves.
According to the researchers, 2% of the U.S. population has an aortic valve with two leaflets instead of three. The leaflets are supposed to open widely and close securely to regulate blood flow. Having bicuspid valves requires regular monitoring by physicians.
“No one’s valve works as well at age 70 as it does at age 20, but in patients with a bicuspid aortic valve, it’s more likely to wear out and require replacement,” the study’s lead author John Forrest said in a news release.
Previous studies of TAVR traditionally excluded bicuspid patients. So, the researchers used data from the STS/ACC TVT Registry that collects data of all commercial TAVR cases in the U.S. The team analyzed 932 patients with bicuspid valve disease who had a TAVR procedure with one of two valves, the Medtronic Evolut R or Evolut Pro, between July 2015 and September 2018.
The patients in the study were already at an increased surgical risk based on factors like their age and underlying medical conditions. Those patients’s results were compared to similar patients with tricuspid valve disease who underwent TAVR during the same time period.
Results of the study showed similar rates of death from any cause at 30 days (2.6% vs. 1.7%) and one year (10.4% vs. 12.1%), as well as the rate of stroke at 30 days (3.4% vs. 2.7%) and one year (3.9% vs. 4.4%).
“This study suggests TAVR is a viable option for patients with bicuspid valve disease who are at increased surgical risk,” Forrest said. “It will be very important to continue to monitor these patients to see how the valves perform in 10 or 15 years.”
The study was published in the journal JACC Cardiovascular Interventions.