Severe acute recoil following transcatheter aortic valve replacement with a self-expanding prosthesis in a heavily calcified bicuspid aortic valve

Bicuspid aortic valve (BAV) is one of the most common congenital valvular heart diseases occurring in 0.5–2% of the general population, in 2–6% of patients with severe aortic stenosis (AS) and up to 20% of octo/nonagenarians undergoing surgery. In this regard, Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic alternative. At the present time, there is not enough evidence to determine which is the best therapeutic approach for AS in BAV. We report a severe acute recoil following TAVR with a self-expanding prosthesis in heavily calcified BAV. In addition, we provide an updated review of the clinical significance of prosthesis underexpansion in the medium-term.

二叶式主动脉瓣（Bicuspid aortic valve, BAV）是最常见的先天性瓣膜性心脏病之一，在普通人群中的发病率为0.5–2%，在重度主动脉瓣狭窄（aortic stenosis, AS）患者中为2–6%，而在接受手术的八旬/九旬老人中高达20%。在此背景下，经导管主动脉瓣置换术（Transcatheter aortic valve replacement, TAVR）已成为一种治疗选择。目前，尚无足够证据确定针对BAV合并AS患者的最佳治疗方案。我们报告了一例重度钙化BAV患者在接受自膨胀假体TAVR术后发生严重急性瓣膜回缩的病例。此外，我们还提供了关于中期假体扩张不足临床意义的最新综述。