Long Term Durability of Bioprosthetic Aortic Valve Replacement in Young Patients With Bicuspid Aortic Stenosis

Treatment of aortic stenosis due to a bicuspid aortic valve (BAV), requires a lifetime strategy due to structural valve degeneration that necessitates redo intervention, such as surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). The researchers looked at outcomes for surgical valve replacement in patients with and without concomitant aortic aneurysms, and have reported excellent operative and reoperative outcomes, including durability at 10 years and valve function. The researchers make a case for performing surgical valve replacement versus TAVR in younger patients for several reasons, including the favorable operative and reoperative safety profile, ability to intervene on concomitant pathology (such as aneurysmal disease and atrial fibrillation), and established long-term durability profile.