AUTHOR=Du Yu , Wang Zhijian , Liu Wei , Guo Yonghe , Han Wei , Shen Hua , Jia Shuo , Yu Yi , Han Kangning , Shi Dongmei , Zhao Yingxin , Zhou Yujie 

TITLE=Transcatheter Aortic Valve Implantation in Sievers Type 0 vs. Type 1 Bicuspid Aortic Valve Morphology: Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.771789

DOI=10.3389/fcvm.2021.771789

ISSN=2297-055X

ABSTRACT=Background Transcatheter aortic valve replacement (TAVR) has achieved satisfactory outcomes in selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%).  Less is known about safety and efficacy of TAVR in type 0 BAV.  This study aims to compare procedural and 30-day outcomes after TAVR between type 0 and type 1 BAV.
Methods Studies comparing outcomes of TAVR in Sievers type 0 vs type 1 BAV were sought from PubMed, EMBASE, Cochrane Library, and Web of Science from inception to May 2021.  Data was extracted on study characteristics and outcomes.  Odds ratio (OR) with 95% confidence interval (CI) were pooled for procedural and 30-day outcomes.
Results Six observational studies were included with determined type 0 BAV in 226 patients and type 1 BAV in 902 patients.  In pooled analyses, incidence of death (OR=1.22; 95% CI 0.48-3.10), stroke (OR=0.54; 95% CI 0.13-2.36), new pacemaker (OR=0.64; 95% CI 0.18-2.23) at 30 days were not significantly different between these 2 BAV morphologies (all p>0.05).  Similarly, compared to type 1 BAV, patients with type 0 BAV had similar incidence of device success (OR=0.62; 95% CI 0.29-1.32), ≥ mild paravavular leak (OR=0.83; 95% CI 0.43-1.60), conversion to surgery (OR=3.36; 95% CI 0.45-25.27), whereas significantly higher risk of coronary compromise (OR=7.18; 95% CI 1.48-34.88).  Heterogeneity of treatment effect across the studies for these outcomes were low.
Conclusions Patients with type 0 BAV seem to have similar procedural and 30-day outcomes after TAVR in comparison with type 1 BAV.