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.