Permanent pacemaker implantation rate
The PPI rate following TAVR for BAV has been reported from 8.0% to 18%
regardless of the used THV (8, 24 ) and from 13.1% to 17.6%
with balloon-expanding SAPIEN 3 THV (11, 25, 26 ). When
comparing the incidence of PPI with tricuspid valve, the results were
not consistent through the studies; one retrospective study showed a
higher PPI rate in the BAV group (5 ), and the others
demonstrated no significant differences between 2 groups (8 –
10, 27 ). The new PPI rate in the BAV group in our study was in the
lower range of previous reports, which was still significantly greater
in the matched comparison to TAV group. A possible explanation of low
rate of new PPI could be the high implantation (implantation depth: 3.9
± 2.2 mm), which was higher than that in the previous study
(implantation depth: 5.5 ± 3.7mm). They reported 18% incidence of new
PPI and 41% incidence of new PPI or new-onset LBBB (24 ).
However, the other studies have not provided implantation depth, thus
further studies on the relation between implantation depth and PPI rate
in bicuspid aortic valve were warranted.