AngioClub: TAVR in the Bicuspid Aortic Valve

In this AngioClub-style episode from the CardioNerds CathMasters, Drs. Amit Goyal, Nazli Okumus, Niko Spilias, and Grant Reed discuss transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve (BAV) stenosis. Through a case of a 71-year-old man with severe aortic stenosis (AS), reduced left ventricular ejection fraction (LVEF), a recent heart failure hospitalization, and a heavily calcified Sievers type 1 BAV, the panel works through TAVR versus surgical aortic valve replacement (SAVR) selection, lifetime management, anatomic and procedural risk (paravalvular leak [PVL], permanent pacemaker [PPM], stroke, annular rupture), balloon/valve sizing, cerebral embolic protection (CEP), and expected LVEF recovery. The episode highlights that BAV is not itself a contraindication to TAVR but demands meticulous CT-based planning and phenotype-specific risk stratification.