NOTION-2 trial: What are the implications for TAVI in young, low-risk patients with bicuspid valves

Ole De Backer (Copenhagen, Denmark) unpacks the results of the NOTION-2 study, in which investigators compared transcatheter aortic valve implantation (TAVI) to surgical aortic valve replacement (SAVR) in younger, low-risk patients.
The trial is the first to randomise younger, low-risk patients with either tricuspid or bicuspid aortic stenosis to a transcatheter or surgical approach, and results have pointed towards less favourable outcomes after TAVI in patients with bicuspid aortic stenosis.
Though he cautioned that the findings warrant validation in larger randomised studies, De Backer comments that this may have implications for the treatment of younger patients with aortic stenosis and bicuspid valve anatomy.