The Puzzle of TAVR for Bicuspid AS: Still Missing a Piece?

(TAVR) was introduced almost 20 years ago as a therapy reserved for patients with severe, symptomatic, and inoperable aortic stenosis (AS). Currently, TAVR is a therapeutic option for patients with severe AS with any degree of estimated surgical risk. TAVR procedures have proliferated as interventional imaging, proceduralists' experience and expertise, and requiguides, valves, etc) have improved and advanced; multicenter clinical trials have accompanied the investigations, seeking to expand TAVR indications, resulting in a robust foundation in procedural success rates, description of complications, and tracked outcomes over time. In 2019, 2 pivotal trials fueled the Conformite Europeenne and the United States Food and Drug Administration approval for TAVR as a therapeutic option in the low-risk surgical patient with severe, symptomatic AS.1,2