Transcatheter Aortic Valve Replacement for Bicuspid Aortic Valve: Challenges and Pitfalls

: Because of the unfavorable anatomic features of bicuspid aortic stenosis (AS), the outcomes of transcatheter aortic valve replacement (TAVR) in bicuspid AS were suboptimal, particularly when using the first-generation transcatheter valves. However, the newer-generation transcatheter valves significantly improved the outcomes of TAVR in bicuspid AS. Nonetheless, long-term durability of transcatheter valves and concomitant aortopathy should be taken into account. Considering the expanding indication of TAVR to lower the surgical risk and a younger population, these issues should be evaluated in future studies.