{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:10:46Z","timestamp":1791447046444,"version":"4.3.3"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The role of transcatheter aortic valve implantation (TAVI) in bicuspid aortic valve stenosis requires further evaluation, particularly as its use has become comparable to surgical aortic valve replacement. We sought to compare midterm outcomes of TAVI and surgical aortic valve replacement in patients with bicuspid aortic valve stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Systematic searches of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials identified studies reporting TAVI and surgical aortic valve replacement outcomes in patients aged \u226560\u2009years with bicuspid aortic valve stenosis. The primary analysis included only comparative studies with interpretable Kaplan\u2013Meier curves. Individual patient data were reconstructed for time\u2010to\u2010event analysis. Sensitivity analyses incorporated noncomparative single\u2010arm studies. Baseline differences and heterogeneity were addressed using landmark analysis, time\u2010varying hazard ratios (HRs), frailty Cox models, and covariate\u2010adjusted restricted mean survival time. The primary outcome was death with or without unplanned rehospitalization and stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Five comparative, risk\u2010adjusted studies (TAVI, 5901; surgical aortic valve replacement, 12\u2009427) were included. At 48\u2010month follow\u2010up, TAVI was associated with a higher hazard for adverse events (HR, 1.62 [95% CI, 1.46\u20131.79];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001 for the composite end point of death, stroke, or rehospitalization at 48 months); landmark analysis showed an initial benefit with TAVI, followed by a reversal at 6 months that was maintained beyond 12 months (12\u201348 months;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001). Time\u2010varying HRs confirmed this trend. Sensitivity analyses, including frailty Cox models on the full cohort and restricted mean survival time analysis, supported the robustness of the findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This meta\u2010analysis found limited midterm benefits (ie, 48 months) of TAVI in bicuspid aortic valve stenosis. These findings should be interpreted considering patient selection, as younger patients with bicuspid aortic valve stenosis are increasingly referred for TAVI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046556","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:33:16Z","timestamp":1773138796000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical Versus Transcatheter Aortic Valve Replacement in Patients Aged &gt;60\u2009Years With Bicuspid Valve Stenosis: A Time\u2010to\u2010Event Data Meta\u2010Analysis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8373-8486","authenticated-orcid":false,"given":"Marco","family":"Moscarelli","sequence":"first","affiliation":[{"name":"Maria Eleonora Hospital, GVM Care and Research","place":["Palermo, Italy"]},{"name":"Imperial College, Department of Surgery and 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UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Pernice","sequence":"additional","affiliation":[{"name":"Maria Eleonora Hospital, GVM Care and Research","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregorio","family":"Zaccone","sequence":"additional","affiliation":[{"name":"Maria Eleonora Hospital, GVM Care and Research","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7064-8695","authenticated-orcid":false,"given":"Mai\u2010Linh","family":"Nguyen Trung","sequence":"additional","affiliation":[{"name":"CHU Sart Tilman","place":["Li\u00e8ge, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0517-1410","authenticated-orcid":false,"given":"Francesco","family":"Giannini","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale 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