Transcatheter aortic valve replacement for bicuspid aortic valve

Transcatheter aortic valve replacement (TAVR) is being routinely done in various centres for aortic stenosis due to tricuspid aortic valves. The number of TAVR procedures are increasing, but the data on bicuspid aortic valves (BAV) is scanty. BAV is commonest abnormality in general population and can progress to severe aortic stenosis. BAVs are a heterogeneous group due to anatomical variations and these valves are large, elliptical with asymmetric calcification. Echocardiography, multidetector CT scans help in diagnosing various phenotypes and in pre TAVR work up in sizing the device. The major issues regarding TAVR in BAVs are improper deployment of the valve , increased risk of strokes, paravalvular leaks, need for second device and requirement for pacemakers. With new generation devices the complication rates are coming down indicating their safe usage in BAVs. Data from TAVR registries and published studies have shown the applicability of TAVR in BAVs with acceptable outcomes.