Refining evidence-based care for diverse bicuspid aortic valve phenotypes: addressing one piece of a larger puzzle

In the accompanying manuscript, Ielasi et al1 present a rigorous core-laboratory analysis of 12 712 patients with severe aortic stenosis referred for transcatheter aortic valve implantation (TAVI). Their work maps the global variability in bicuspid aortic valve (BAV) morphology in this referral population. BAV was identified in 25% of this cohort. Compared with their tricuspid counterparts, these patients typically presented at a younger age, were predominantly male and exhibited larger annular and aortic root dimensions alongside heavier valve calcification.