Bicuspid Aortic Valve dilemma: TAVI or SAVR? Insights from the NOTION-2 trial

Indian J Thorac Cardiovasc Surg. 2024 Sep;40(5):645-647. doi: 10.1007/s12055-024-01809-3. Epub 2024 Aug 5.

Abstract

The Nordic Aortic Valve Intervention-2 (NOTION-2) trial is the first randomized controlled trial to compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low-risk patients, specifically focusing on relatively younger patients and those with bicuspid valves. It randomized 370 patients (mean age 71 years) to assess outcomes at 1 year. Results indicated a higher composite primary endpoint rate for TAVI (10.2%) compared to SAVR (7.1%) in the overall cohort, with even more pronounced differences in patients with bicuspid valves (14.3% for TAVI vs. 3.9% for SAVR). The risk of death or disabling stroke at 1 year was also three times higher with TAVI.

Keywords: Bicuspid valves; NOTION-2; SAVR; TAVI; Young.