{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:51:58Z","timestamp":1787813518618,"version":"build-2784847793"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T00:00:00Z","timestamp":1603497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T00:00:00Z","timestamp":1603497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Oulu including Oulu University Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To compare the outcomes after surgical (SAVR) and transcatheter aortic valve replacement (TAVR) for severe stenosis of bicuspid aortic valve (BAV).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We evaluated the early and mid-term outcome of patients with stenotic BAV who underwent SAVR or TAVR for aortic stenosis from the nationwide FinnValve registry.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The FinnValve registry included 6463 AS patients and 1023 (15.8%) of them had BAV. SAVR was performed in 920 patients and TAVR in 103 patients with BAV. In the overall series, device success after TAVR was comparable to SAVR (94.2% vs. 97.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.115). TAVR was associated with increased rate of mild-to-severe paravalvular regurgitation (PVR) (19.4% vs. 7.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and of moderate-to-severe PVR (2.9% vs. 0.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.053). When newer-generation TAVR devices were evaluated, mild-to-severe PVR (11.9% vs. 7.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.223) and moderate-to-severe PVR (0% vs. 0.7%, <jats:italic>p<\/jats:italic>\u2009=\u20091.000) were comparable to SAVR. Type 1\u00a0N-L and type 2 L-R\/R-N were the BAV morphologies with higher incidence of mild-to-severe PVR (37.5% and 100%, adjusted for new-generation prostheses <jats:italic>p<\/jats:italic>\u2009=\u20090.025) compared to other types of BAVs. Among 75 propensity score-matched cohorts, 30-day mortality was 1.3% after TAVR and 5.3% after SAVR (<jats:italic>p<\/jats:italic>\u2009=\u20090.375), and 2-year mortality was 9.7% after TAVR and 18.7% after SAVR (<jats:italic>p<\/jats:italic>\u2009=\u20090.268)<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In patients with stenotic BAV, TAVR seems to achieve early and mid-term results comparable to SAVR. Type 1\u00a0N-L and type 2 L-R\/R-N BAV morphologies had higher incidence of PVR. Larger studies evaluating different phenotypes of BAV are needed to confirm these findings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical trial registration<\/jats:title>\n                <jats:p>ClinicalTrials.gov Identifier: NCT03385915.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphic abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-020-01761-3","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T15:02:52Z","timestamp":1603551772000},"page":"429-439","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Transcatheter and surgical aortic valve replacement in patients with bicuspid aortic valve"],"prefix":"10.1007","volume":"110","author":[{"given":"Annastiina","family":"Husso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhani","family":"Airaksinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatu","family":"Juvonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Laine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Dahlbacka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Virtanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Niemel\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"M\u00e4kikallio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko","family":"Savontaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Eskola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Raivio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Valtola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-8186","authenticated-orcid":false,"given":"Fausto","family":"Biancari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,24]]},"reference":[{"key":"1761_CR1","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1017\/S1047951100005400","volume":"9","author":"HM Pauperio","year":"1999","unstructured":"Pauperio HM, Azevedo AC, Ferreira CS (1999) The aortic valve with two leaflets: a study in 2,000 autopsies. Cardiol Young 9:488\u2013498","journal-title":"Cardiol Young"},{"key":"1761_CR2","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1136\/heart.88.4.321","volume":"88","author":"CM Otto","year":"2002","unstructured":"Otto CM (2002) Calcification of bicuspid aortic valves. Heart 88:321\u2013322","journal-title":"Heart"},{"key":"1761_CR3","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1136\/heartjnl-2016-309916","volume":"103","author":"A Masri","year":"2017","unstructured":"Masri A, Svensson LG, Griffin BP, Desai MY (2017) Contemporary natural history of bicuspid aortic valve disease: a systematic review. Heart 103:1323\u20131330","journal-title":"Heart"},{"key":"1761_CR4","doi-asserted-by":"publisher","first-page":"2789","DOI":"10.1016\/j.jacc.2009.12.068","volume":"55","author":"SC Siu","year":"2010","unstructured":"Siu SC, Silversides CK (2010) Bicuspid aortic valve disease. J Am Coll Cardiol 55:2789\u20132800","journal-title":"J Am Coll Cardiol"},{"key":"1761_CR5","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","volume":"380","author":"MJ Mack","year":"2019","unstructured":"Mack MJ, Leon MB, Thourani VH et al (2019) Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med 380:1695\u20131705","journal-title":"N Engl J Med"},{"key":"1761_CR6","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","volume":"380","author":"JJ Popma","year":"2019","unstructured":"Popma JJ, Deeb GM, Yakubov SJ et al (2019) Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med 380:1706\u20131715","journal-title":"N Engl J Med"},{"key":"1761_CR7","doi-asserted-by":"publisher","first-page":"2330","DOI":"10.1016\/j.jacc.2014.09.039","volume":"64","author":"D Mylotte","year":"2014","unstructured":"Mylotte D, Lefevre T, S\u00f8ndergaard L et al (2014) Transcatheter aortic valve replacement in bicuspid aortic valve disease. J Am Coll Cardiol 64:2330\u20132339","journal-title":"J Am Coll Cardiol"},{"key":"1761_CR8","doi-asserted-by":"publisher","first-page":"2579","DOI":"10.1016\/j.jacc.2017.03.017","volume":"69","author":"SH Yoon","year":"2017","unstructured":"Yoon SH, Bleiziffer S, De Backer O et al (2017) Outcomes in transcatheter aortic valve replacement for bicuspid versus tricuspid aortic valve stenosis. J Am Coll Cardiol 69:2579\u20132589","journal-title":"J Am Coll Cardiol"},{"key":"1761_CR9","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1002\/ccd.27340","volume":"91","author":"G Reddy","year":"2018","unstructured":"Reddy G, Wang Z, Nishimura RA et al (2018) Transcatheter aortic valve replacement for stenotic bicuspid aortic valves: systematic review and meta analyses of observational studies. Catheter Cardiovasc Interv 91:975\u2013983","journal-title":"Catheter Cardiovasc Interv"},{"key":"1761_CR10","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1161\/CIRCULATIONAHA.119.040333","volume":"141","author":"SA Halim","year":"2020","unstructured":"Halim SA, Edwards FH, Dai D et al (2020) Outcomes of transcatheter aortic valve replacement in patients with bicuspid aortic valve disease: A report from the Society of Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapy Registry. Circulation 141:1071\u20131079","journal-title":"Circulation"},{"key":"1761_CR11","first-page":"e521","volume":"129","author":"RA Nishimura","year":"2014","unstructured":"Nishimura RA, Otto CM, Bonow RO et al (2014) 2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines. Circulation 129:e521-643","journal-title":"Circulation"},{"key":"1761_CR12","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","volume":"38","author":"H Baumgartner","year":"2017","unstructured":"Baumgartner H, Falk V, Bax JJ et al (2017) 2017 ESC\/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 38:2739\u20132791","journal-title":"Eur Heart J"},{"key":"1761_CR13","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1016\/j.jcin.2019.06.037","volume":"12","author":"A Elbadawi","year":"2019","unstructured":"Elbadawi A, Saad M, Elgendy IY et al (2019) Temporal trends and outcomes of transcatheter versus surgical aortic valve replacement for bicuspid aortic valve stenosis. JACC Cardiovasc Interv 12:1811\u20131822","journal-title":"JACC Cardiovasc Interv"},{"key":"1761_CR14","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.1001\/jama.2019.7108","volume":"321","author":"RR Makkar","year":"2019","unstructured":"Makkar RR, Yoon SH, Leon MB et al (2019) Association between transcatheter aortic valve replacement for bicuspid vs tricuspid aortic stenosis and mortality or stroke. JAMA 321:2193\u20132202","journal-title":"JAMA"},{"key":"1761_CR15","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1016\/j.jtcvs.2007.01.039","volume":"133","author":"HH Sievers","year":"2007","unstructured":"Sievers HH, Schmidtke C (2007) A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg 133:1226\u20131233","journal-title":"J Thorac Cardiovasc Surg"},{"key":"1761_CR16","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.1093\/eurheartj\/ehs255","volume":"33","author":"AP Kappetein","year":"2012","unstructured":"Kappetein AP, Head SJ, G\u00e9n\u00e9reux P et al (2012) Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. Eur Heart J 33:2403\u20132418","journal-title":"Eur Heart J"},{"key":"1761_CR17","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/s13019-015-0292-z","volume":"10","author":"F Biancari","year":"2015","unstructured":"Biancari F, Ruggieri VG, Perrotti A et al (2015) European multicenter study on coronary artery bypass grafting (E-CABG registry): study protocol for a prospective clinical registry and proposal of classification of postoperative complications. J Cardiothorac Surg 10:90","journal-title":"J Cardiothorac Surg"},{"key":"1761_CR18","doi-asserted-by":"publisher","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","volume":"150","author":"AS Levey","year":"2009","unstructured":"Levey AS, Stevens LA, Schmid CH et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604\u2013612","journal-title":"Ann Intern Med"},{"key":"1761_CR19","doi-asserted-by":"publisher","first-page":"20520","DOI":"10.1016\/S0140-6736(98)04402-X","volume":"353","author":"K Rockwood","year":"1999","unstructured":"Rockwood K, Stadnyk K, MacKnight C et al (1999) A brief clinical instrument to classify frailty in elderly people. Lancet 353:20520\u201320526","journal-title":"Lancet"},{"key":"1761_CR20","unstructured":"The Society of Thoracic Surgeons. Online STS Adult Cardiac Surgery Risk Calculator https:\/\/riskcalc.sts.org\/stswebriskcalc\/#\/2017 (Accessed Nov 2018)"},{"issue":"20","key":"1761_CR21","first-page":"30763","volume":"S1936\u20138798","author":"JK Forrest","year":"2020","unstructured":"Forrest JK, Kaple RK, Ramlawi B et al (2020) (2020) Transcatheter aortic valve replacement in bicuspid versus tricuspid aortic valves from the STS\/ACC TVT registry. JACC Cardiovasc Interv S1936\u20138798(20):30763\u201330769","journal-title":"JACC Cardiovasc Interv"},{"key":"1761_CR22","doi-asserted-by":"publisher","first-page":"2477","DOI":"10.1016\/S0140-6736(15)60308-7","volume":"385","author":"MJ Mack","year":"2015","unstructured":"Mack MJ, Leon MB, Smith CR et al (2015) 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 385:2477\u20132484","journal-title":"Lancet"},{"key":"1761_CR23","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1016\/j.jacc.2016.06.041","volume":"68","author":"SH Yoon","year":"2016","unstructured":"Yoon SH, Lef\u00e8vre T, Ahn JM et al (2016) Transcatheter aortic valve replacement with early- and new-generation devices in bicuspid aortic valve stenosis. J Am Coll Cardiol 68:1195\u20131205","journal-title":"J Am Coll Cardiol"},{"key":"1761_CR24","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1016\/j.jcin.2016.01.002","volume":"9","author":"GY Perlman","year":"2016","unstructured":"Perlman GY, Blanke P, Dvir D et al (2016) Bicuspid aortic valve stenosis: favorable early outcomes with a next-generation transcatheter heart valve in a multicenter study. JACC Cardiovasc Interv 9:817\u2013824","journal-title":"JACC Cardiovasc Interv"},{"key":"1761_CR25","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1001\/jamacardio.2017.1685","volume":"2","author":"RS Hira","year":"2017","unstructured":"Hira RS, Vemulapalli S, Li Z et al (2017) Trends and outcomes of off-label use of transcatheter aortic valve replacement: insights from the NCDR STS\/ACC TVT registry. JAMA Cardiol 2:846\u2013854","journal-title":"JAMA Cardiol"},{"key":"1761_CR26","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.1016\/j.jacc.2018.08.1033","volume":"72","author":"R Waksman","year":"2018","unstructured":"Waksman R, Rogers T, Torguson R et al (2018) Transcatheter aortic valve replacement in low-risk patients with symptomatic severe aortic stenosis. J Am Coll Cardiol 72:2095\u20132105","journal-title":"J Am Coll Cardiol"},{"key":"1761_CR27","doi-asserted-by":"publisher","first-page":"877","DOI":"10.4244\/EIJ-D-18-00460","volume":"14","author":"PW Serruys","year":"2018","unstructured":"Serruys PW, Modolo R, Reardon M et al (2018) One-year outcomes of patients with severe aortic stenosis and an STS PROM of less than three percent in the SURTAVI trial. EuroIntervention 14:877\u2013883","journal-title":"EuroIntervention"},{"key":"1761_CR28","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.amjcard.2014.05.063","volume":"114","author":"J Kochman","year":"2014","unstructured":"Kochman J, Huczek Z, Scis\u0142o P et al (2014) Comparison of one- and 12-month outcomes of transcatheter aortic valve replacement in patients with severely stenotic bicuspid versus tricuspid aortic valves (results from a multicenter registry). Am J Cardiol 114:757\u2013762","journal-title":"Am J Cardiol"},{"key":"1761_CR29","doi-asserted-by":"publisher","first-page":"E88","DOI":"10.1002\/ccd.25948","volume":"86","author":"F Philip","year":"2015","unstructured":"Philip F, Faza NN, Schoenhagen P et al (2015) Aortic annulus and root characteristics in severe aortic stenosis due to bicuspid aortic valve and tricuspid aortic valves: implications for transcatheter aortic valve therapies. Catheter Cardiovasc Interv 86:E88-98","journal-title":"Catheter Cardiovasc Interv"},{"key":"1761_CR30","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.jcin.2012.11.014","volume":"6","author":"HB Ribeiro","year":"2013","unstructured":"Ribeiro HB, Nombela-Franco L, Urena M et al (2013) Coronary obstruction following transcatheter aortic valve implantation: a systematic review. JACC Cardiovasc Interv 6:452\u2013461","journal-title":"JACC Cardiovasc Interv"},{"key":"1761_CR31","doi-asserted-by":"publisher","first-page":"732","DOI":"10.4244\/EIJV10I6A126","volume":"10","author":"L Buellesfeld","year":"2014","unstructured":"Buellesfeld L, Stortecky S, Heg D et al (2014) Extent and distribution of calcification of both the aortic annulus and the left ventricular outflow tract predict aortic regurgitation after transcatheter aortic valve replacement. EuroIntervention 10:732\u2013738","journal-title":"EuroIntervention"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-020-01761-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-020-01761-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-020-01761-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T19:15:04Z","timestamp":1635016504000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-020-01761-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,24]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["1761"],"URL":"https:\/\/doi.org\/10.1007\/s00392-020-01761-3","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,24]]},"assertion":[{"value":"10 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Dr. A. Husso received an educational grant from Abbott; Dr. M.P.O. Virtanen received educational grants from Abbott and Edwards Lifesciences; Dr. Mikko Savontaus is a proctor for Medtronic; Dr. Mika Laine is a proctor for Boston Scientific. The other coauthors do not have any conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was approved from the institutional research boards of each participating center.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Waived.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors gave their consent to publish this article.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}