Treatment of Severe Aortic Stenosis in Bicuspid Aortic Valve
This protocol addresses severe aortic stenosis arising specifically in patients with a bicuspid aortic valve (BAV) — a congenital anatomical variant that is central to treatment selection and intervention planning.
Clinical Scenario
The patient has severe aortic stenosis on the background of a bicuspid aortic valve. This combination requires careful anatomical assessment, as the bicuspid morphology directly influences which intervention is appropriate and what additional aortic pathology may coexist.
Treatment Approach
Surgical aortic valve replacement is the primary mode of treatment in this setting. Whether an alternative interventional strategy may apply depends on the patient's individual surgical risk profile and anatomical characteristics — the full criteria and decision pathway are specified in the protocol.
Complete selection criteria, intervention algorithm, and anatomical considerations are available in the full protocol →
References
DOI: 10.1093/eurheartj/ehaf194
For the above-mentioned reasons, SAVR remains the primary mode of treatment for stenotic BAV, particularly if patients are young or have coexistent aortopathy or unfavourable valve morphology.
TAVI may be considered for the treatment of severe BAV stenosis in patients at increased surgical risk, if the anatomy is suitable.