ArticleThe international journal of cardiovascular imaging2020
Challenges of recognizing bicuspid aortic valve in elderly patients undergoing TAVR.
Article in The international journal of cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 22 citations in OpenAlex.
- Midterm Clinical and Echocardiographic Outcomes After Transcatheter Aortic Valve Replacement in Patients With Severe Bicuspid Aortic Valve Stenosis.Journal of the American Heart Association · 2026Article
- Methods for improved bileaflet aortic valve detection prior to transcatheter aortic valve replacement.Frontiers in cardiovascular medicine · 2026Article
- Transcatheter Treatment of Bicuspid Aortic Valve Stenosis: From Observational Studies to Randomized Clinical Trials.Structural heart : the journal of the Heart Team · 2025Review
- Temporal Dynamics of the Association Between Acute Kidney Injury and Mortality After Transcatheter Aortic Valve Implantation: Insights from Time-Varying and Landmark Survival Analyses.Journal of cardiovascular development and disease · 2025Article
- Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis.Journal of cardiovascular development and disease · 2023Review
- Calcium Fracture and Device Over Expansion in Transcatheter Aortic Valve Replacement for Bicuspid Aortic Valves.Annals of biomedical engineering · 2023Article
- Article
- The Natural History of Bicuspid Aortic Valve Disease.Structural heart : the journal of the Heart Team · 2023Review
- Clinical Research on Transcatheter Aortic Valve Replacement for Bicuspid Aortic Valve Disease: Principles, Challenges, and an Agenda for the Future.Structural heart : the journal of the Heart Team · 2023Review
- [Anythink for CT-based aorta root measurements before transcatheter aortic valve replacement: measurement consistency with 3mensio and impact on short-term prognosis].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2022Article
- Mind the gap: avoiding paravalvular leak using computer simulation in bicuspid transcatheter aortic valve replacement-a case report.European heart journal. Case reports · 2022Article
- Transcatheter aortic valve replacement for bicuspid aortic valve disease: does conventional surgery have a future?Annals of cardiothoracic surgery · 2022Review
- Treatment of Bicuspid Aortic Valve Stenosis with TAVR: Filling Knowledge Gaps Towards Reducing Complications.Current cardiology reports · 2022Review
- The Presence of Calcified Raphe Is an Independent Predictor of Adverse Long-Term Clinical Outcomes in Patients With Bicuspid Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement.Frontiers in cardiovascular medicine · 2022Article
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recognition of bicuspid aortic valve (BAV) may be challenging in elderly patients with heavily calcified aortic valves undergoing transcatheter aortic valve replacement (TAVR). In this subset, the diagnostic value of pre-procedural echocardiography in clinical routine is unknown. From a total of 2583 patients undergoing TAVR in our center, we determined the rate of BAV detected by routine echocardiography as documented in the medical records. Pre-procedural multidetector computed tomography (MDCT) images were retrospectively analyzed for the presence of BAV and served as reference standard. Using MDCT criteria, BAV was found in 235 (9.1%) (age 80.1 years [interquartile range 76.4; 83.4], 44.3% female). Of these, only 27/235 (11.5%) had been identified as BAV according to echocardiography reports, whereas 6/2348 (0.3%) with TAV had been wrongly diagnosed as BAV (p < 0.001; sensitivity 11.5%, specificity 99.7%). Correct diagnosis of BAV by echocardiography was more likely when transesophageal echocardiography was available (odds ratio (OR) 5.12 [95% confidence interval (CI) 2.22; 11.80]; p < 0.001) and the reader was experienced (OR 5.28 [95% CI 1.55; 18.04]; p = 0.008). Furthermore, correct diagnosis of BAV was more likely in bicommissural-type BAV (OR 2.22 [95% CI 0.90; 5.48]; p = 0.08), whereas heavy aortic valve calcification lead to misdiagnosis (OR 0.39 [95% CI 0.14; 1.06]; p = 0.07). In elderly patients with severe aortic stenosis that are candidates for TAVR, the presence of BAV may be considerably underestimated when relying solely on routine echocardiography. This underlines the value of MDCT for the screening of BAV in this patient population.
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