Impact of left ventricular outflow calcification on early outcome in patient with bicuspid aortic valve undergoing transcatheter aortic valve implantation

In the last years the world of interventional cardiology is witnessing a paradigmatic shift in the treatment of AS. Nowadays, TAVI represents the main procedure for the majority of patient affected by aortic stenosis . After the results of the PARTNER III and EVOLUT LOW RISK trial, TAVR indications are expanding to low surgical risk patient. The presence of LVOT calcification has been established as anatomical risk factor for early and late complication and poor outcome. In early generation TAVI prosthesis, the presence of LVOT calcification has been associated with an augmented risk of peri-valvular regurgitation. Moreover, the impact on outcome of LVOT calcification in patient undergoing TAVR with new generation device was outlined in a study by Lara Waldschmidt et al. In this retrospective single center study 1207 patient undergoing TAVR were screened for the presence of LVOT calcification on multi-slice computed tomography (MSCT) and patients with significant LVOT calcification resulted to be associated with worse short-term outcomes and higher one year mortality when compared to patient without LVOT calcification. The aim of the study is to assess the impact on early device outcomes of LVOT calcification in a population of patient with BA undergoing transcatheter aortic valve implantation. In accordance with Valve Academic Research Consortium 3 (VARC-3) criteria, also stroke, PM rates and PVR, have been collected as well .