Safety and efficacy of transcatheter aortic valve implantation in bicuspid aortic valve stenosis: a propensity-matched multicentre study

BACKGROUND: Current evidence regarding transcatheter aortic valve implantation (TAVI) in bicuspid aortic valve (BAV) is primarily based on Western registries, whereas data from Africa and the Middle East are scarce. OBJECTIVES: To assess the safety and efficacy of contemporary TAVI in patients with BAV, in comparison with tricuspid aortic valve (TAV). METHODS: = 267). Outcomes were adjudicated in accordance with Valve Academic Research Consortium-3 (VARC-3) criteria, with follow-up extending to 12 months. Propensity score (PS) matching (1:1) was applied to achieve balance in baseline characteristics. RESULTS: = 0.357). The incidence of all-cause mortality, stroke, and new permanent pacemaker (PPM) implantation at 1 year did not differ meaningfully between groups. CONCLUSIONS: In this prospective multicenter cohort, contemporary TAVI achieved early and mid-term outcomes in carefully selected BAV patients comparable to tricuspid anatomy. These findings suggest the feasibility of TAVI in carefully selected BAV anatomies when guided by detailed computed tomography (CT)-based assessment and tailored procedural planning.