Transcatheter aortic valve implantation in patients with tricuspid, bicuspid and bioprosthetic valves: observations from COMPARE-TAVI 1.

Patient demographics differed across valve anatomy groups, with tricuspid valve patients being slightly older than bicuspid and bioprosthetic valve patients.

• Tricuspid valve group: N=892, median age 82 years
• Bicuspid valve group: N=98, median age 78 years
• Bioprosthetic valve group: N=40, median age 80 years
• All patients were treated with transfemoral TAVI and randomized to one of two balloon-expandable valves in the COMPARE-TAVI 1 trial

Procedural outcomes were similar across all three valve anatomy groups.

• No statistically significant differences in procedural outcomes were observed between tricuspid, bicuspid, and bioprosthetic valve groups
• All patients were all-comer patients treated with transfemoral TAVI
• Both balloon-expandable valve types were represented across groups

There were no differences in death or bleeding at 30 days across the three valve anatomy groups.

• Death rates at 30 days were not significantly different between tricuspid, bicuspid, and bioprosthetic valve groups
• Bleeding events at 30 days were also similar across groups
• Comparisons were made between bicuspid and bioprosthetic groups versus the tricuspid group as reference

Stroke was more frequent among patients with bicuspid valves at 30 days compared to other groups.

• Seven stroke events (n=7) occurred in the bicuspid valve group at 30 days
• This was noted as more frequent compared to the tricuspid valve group
• The bicuspid valve group comprised 98 patients total

No patients with bioprosthetic valves required a new pacemaker within 30 days after TAVI.

• New pacemaker implantation occurred in zero (n=0) bioprosthetic valve patients at 30 days
• New pacemaker rate was less frequent among patients with bioprosthetic valves compared to tricuspid valve patients at 30 days
• The bioprosthetic valve group comprised 40 patients total
• This finding was highlighted as a notable conclusion of the study

The need for reoperation was more frequent among patients with bicuspid valves.

• Three patients (n=3) with bicuspid valves required reoperation
• Reoperation rate was higher in the bicuspid group compared to tricuspid valve patients
• The bicuspid valve group comprised 98 patients total

There were no differences in death, myocardial infarction, percutaneous revascularization, or endocarditis at 1 year across valve anatomy groups.

• One-year outcomes for death, MI, percutaneous revascularization, and endocarditis were similar between tricuspid, bicuspid, and bioprosthetic valve groups
• Longer-term major adverse outcomes did not differ significantly by valve anatomy type
• Follow-up extended to 1 year for all outcome comparisons