Transcatheter Aortic Valve Replacement: An Update in Bicuspid Aortic Valve Disease

Published: 13 July 2020

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    Nicolas M Van Mieghem, Basel Ramlawi, Didier Tchétché, Firas Zahr
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Overview

Considering the promising outcomes and FDA approval in low-risk patients, the number of transcatheter aortic valve replacement (TAVR) procedures is expected to increase significantly in the coming years. According to the most recent data presented at the American College of Cardiology (ACC) 2020, bicuspid aortic valve disease (BAV) patients who undergo TAVR procedures had a low risk of death or disabling stroke and high rate of success with a newer self-expanding artificial valve (Evolut supra-annular self-expanding valves, Medtronic). Further, BAV patients reported to have a similar rate of death compared with tricuspid aortic valve disease patients following TAVR using the balloon-expandable valve (Edwards Sapien 3, Edwards Lifesciences).

Improving efficacy and reduction in operator variability is essential to ensure the adoption of TAVR for BAV patients. In particular, the BAV morphologies will remain challenging and require accurate pre- and peri-procedural work up.

This programme has therefore been designed for an audience of cardiologists and surgeons to build their understanding of bicuspid valve disease and classifications, clinical trial data supporting TAVR in low-risk bicuspid patients, implant techniques, and device considerations for bicuspid patients.
 

EBAC Accreditation

This video series was funded by an unrestricted educational grant from Medtronic.

Learning Objectives

  • Describe the Latest Data in Bicuspid Valve Disease and Understand the Classifications
  • Critically Evaluate Clinical Trial Data in TAVR in Low-Risk Bicuspid Patients
  • Review Implant Techniques and Device Considerations for Bicuspid Patients

More from this programme

Part 1

Programme Introduction and TAVR in Low Risk Bicuspid Patients: Critical Review of the Clinical Evidence

Part 2

Implant Techniques and Device Selections for Bicuspid Patients

Part 3

TAVR in Bicuspid Patients: Case Reviews

Part 4

Discussion and Q&As

Faculty Biographies

Nicolas M Van Mieghem

Nicolas M Van Mieghem

Medical Director

Prof Nicolas Maria Van Mieghem is an Interventional cardiologist at Thoraxcenter, Erasmus MC, Rotterdam, NL decided to pursue a career that would help others. “I enjoy the feeling of being able to help someone or do something important for them". His father was a general cardiologist and one of his biggest influences early in his career.

Prof Van Mieghem initially intended to train as a cardiac surgeon but decided to specialise in interventional cardiology instead, following advice from a mentor. This decision was cemented when he read the first-in-human case report of transcatheter aortic valve implantation (TAVI) in Circulation by Alain Cribier in 2002. Prof Van Mieghem believes that great cardiologist genuinely cares for their patients. He names Gary Roubin, Dr Manu Malbrain and Professor Patrick Serruys among his mentors. 

His current research focuses on cerebral embolic protection during TAVI and the search for improved…

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Basel Ramlawi

Basel Ramlawi

Valley Health System, Virginia, US

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Didier Tchétché

Didier Tchétché

Didier Tchétché, (Clinique Pasteur, Toulouse, France) Graduated from the University of Paris V where Dr Tchétché obtained his post-graduate diploma of cardiovascular pathology in 2004. From 2004 to 2005, he completed a 12-month fellowship period in the Hemodynamic and Interventional Cardiology department of Clinique Pasteur in Toulouse and from 2005 to 2007 he was Head Assistant at the intensive care unit of Bichât Hospital in Paris.

In 2008, he joined the interventional cardiovascular group in Clinique Pasteur, Toulouse, and he is currently Head of the Structural programme with an experience of more than 5000 TAVI procedures. His main areas of interest are coronary interventions and valvular heart disease. He has been actively involved in many clinical trials involving new technologies and devices in the field of interventional cardiology.

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Firas Zahr

Firas Zahr

Director of Interventional Cardiology and Associate Professor of Medicine

Dr Firas Zahr is an Associate Professor of Medicine in the Division of Cardiovascular Medicine at Oregon Health and Science University. At the same institution, he is the Director of Interventional Cardiology and Co-Director of the Structural Heart Disease program.

Dr Zahr earned his MD from the University of Damascus in 2002 and has been in practice for more than 20 years. He further specialised with an Interventional Cardiology Structural Fellowship at the University of Pittsburgh Medical Center.

He is a Fellow of the American College of Cardiology, and his research focuses on cardiac catheterization, transcatheter valve therapies and interventional cardiology. Alongside his investigations, Dr Zahr has written over a hundred publications in peer reviewed journals focusing on valvular heart disease management.

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