TAVI and Bicuspid Aortic Valve: Check the Inter-Commissural Space!

Transcatheter aortic valve implantation (TAVI) in cases of bicuspid aortic valve (BAV) with a large aortic annulus remains challenging and is rarely performed due to the risk of residual paravalvular aortic leakage. A SAPIEN 3 prosthesis was successfully implanted in two BAV patients each with a relatively large aortic annulus. The New SAPIEN 3 design, coupled with good sealing at the level of the inter-commissural space of the bicuspid valve, seems to account for the efficiency of TAVI for BAV with a large annulus.