{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:51:59Z","timestamp":1791525119156,"version":"4.3.4"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcatheter aortic valve replacement (TAVR) addresses valvular obstruction but leaves concomitant ascending aortic dilatation untreated. Whether bicuspid aortic valve (BAV) morphology inherently accelerates post-TAVR aortic expansion compared with tricuspid aortic valves (TAV) remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 189 older adults (BAV,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200987; TAV,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009102) with severe aortic stenosis and ascending aortic dilatation (\u22654.5\u2005cm) undergoing TAVR. Annualized aortic expansion rates were evaluated utilizing linear mixed-effects models derived from serial computed tomography angiography over a median 27.0-month follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No ascending aortic dissection, rupture, or elective aortic interventions occurred during follow-up. The adjusted annualized expansion rate at the mid-ascending aorta was low and comparable between the BAV and TAV cohorts (0.43 vs. 0.39\u2005mm\/year; interaction\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.364). Progression rates at the distal ascending aorta and sinuses of Valsalva similarly demonstrated no significant morphological differences. No patient exhibited rapid progression (&amp;gt;5\u2005mm\/year). Although moderate or greater paravalvular leakage occurred exclusively in BAV patients (4.8% vs. 0.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043), its overall incidence was low (2.2%); however, the extremely small number of cases precluded a definitive statistical assessment of its impact on longitudinal aortic expansion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this selected cohort, dilated ascending aortas exhibited slow intermediate-term expansion following transfemoral TAVR utilizing self-expanding valves, with comparable rates between BAV and TAV morphologies. These findings suggest that conservative management of concomitant ascending aortic dilatation may be a reasonable strategy in older TAVR candidates during intermediate-term follow-up, provided that strict blood pressure control and rigorous imaging surveillance are maintained.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1878963","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:33:19Z","timestamp":1791523999000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal changes in dilated ascending aorta after transfemoral TAVR: a comparative analysis of bicuspid and tricuspid aortic valves"],"prefix":"10.3389","volume":"13","author":[{"given":"Qichen","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Fujian Provincial Center for Cardiovascular Medicine, Union Hospital, Fujian Medical 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