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The following is a summary of “Incidence and predictors of continued ascending aortic dilatation after TAVI in patients with bicuspid aortic stenosis,” published in the September 2024 issue of Cardiology by Jia et al.

Patients with bicuspid aortic stenosis (AS) often have ascending aortic (AAo) dilatation, which is frequently left untreated during transcatheter aortic valve implantation (TAVI). 

Researchers conducted a retrospective study investigating the natural progression and underlying mechanisms of AAo dilatation following TAVI for bicuspid AS.

They included patients who had native bicuspid AS, a baseline AAo maximum diameter greater than 40 mm at baseline, were treated with TAVI, and had post-TAVI computed tomography (CT) scans available after 1 year, AAo dilatation was categorized as either continuous (an increase of 2 mm or more) or stable (an increase or decrease of less than 2 mm). Univariate and multivariate logistic regression analyses were conducted to determine the factors associated with continuous AAo dilatation post-TAVI. 

The results showed 61 patients with a mean AAo maximum diameter of 45.6 ± 3.9 mm at baseline with a median follow-up of 2.9 years; 85% of patients maintained stable AAo dimensions. Continuous AAo dilatation was found in 15% of patients at a rate of 1.4 mm per year.  Factors associated with continuous AAo dilatation were the ratio of raphe length to annulus mean diameter (OR 4.09, 95% CI [1.40–16.7], P=0.022), TAV eccentricity at the leaflet outflow level (OR 2.11, 95%CI [1.12–4.53], P=0.031), and maximum transprosthetic gradient (OR 1.30, 95%CI [0.99–1.73], P=0.058).

They concluded that ascending aortic dilatation remained stable in most patients undergoing TAVI for bicuspid AS.

Source: link.springer.com/article/10.1007/s00392-024-02545-9