Patient selection
This study was a retrospective registry from 3 centers (Helsinki
University Hospital, Finland; Oulu University Hospital, Finland and
Shonan Kamakura General Hospital, Japan). Patients with BAV stenosis who
underwent TAVR were eligible for the study. Out of 195 eligible patients
from 3 centers, 26 patients (intraprocedural death: 0, implantation
failure: 2, poor CT image quality: 1, poor angiogram quality: 5, prior
PPI: 17) were excluded from the analysis (Figure 1 ). After
exclusion, 169 patients remained for further analysis. BAV morphology
was confirmed by pre-procedural MDCT and determined using the Sievers
classification (20 ). TAV cohort was established to compare with
BAV cohort by using propensity score (PS) matching. The inclusion
criteria of TAV cohort were patients with TAV stenosis who underwent
TAVR at Helsinki university hospital. Exclusion criteria were the same
as the BAV cohort. THV size was selected based on the integration of
preprocedural MDCT assessment including annulus area size and
inter-commissural distance (ICD) at 4mm above the annulus by the
multidisciplinary heart team at the individual hospital. This study was
conformed to the Declaration of Helsinki and approved by the
Institutional Review Board in Helsinki.