Prediction of Suitable Fluoroscopic Implantation Planes for Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve Anatomy - Clinical Validation of a Novel Approach

Objectives: Treatment of bicuspid aortic valve stenosis (BAV) by transcatheter aortic valve implantation (TAVI) is increasingly performed and shows promising results. Nevertheless, TAVI in BAV is generally considered as more challenging than in regular tricuspid anatomy. One of the underlying reasons can be the difficulty to determine suitable fluoroscopic implantation planes, especially as the regular TAVI approach based on the three cusps' nadirs is not feasible in BAV by definition. We present a method to predict implantation planes by assessment of the preoperative CT scan, and describe its impact on our center's implantations.