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TAVI In Severe Bicuspid Aortic Valve Disease

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An interactive live case collaboration between the Thoraxcenter, Erasmus MC and Interventional Cardiology Review.


Nicolas M Van Mieghem

Nicolas M Van Mieghem

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Bicuspid aortic valve disease is currently a challenge for Transcatheter Aortic Valve Implantation (TAVI). Bicuspid disease has so far been an exclusion criterion in randomized TAVI trials. Issues with severe bicuspid and TAVI include significant periprosthetic regurgitation and device malposition.

This live case will feature a mechanically expandable transcatheter heart valve with complete repositionability and a sealing skirt. These features will be discussed in the context of bicuspid valve disease treatment.

Learning Objectives

  • Performing a TAVI implantation in a bicuspid valve
  • Discussing specific valve features which impact outcomes
  • Explaining implantation from A to Z

Target Audience

  • Interventional cardiologists
  • TAVI operators
  • Nurses and technicians involved in structural heart programs
  • Interventional cardiology fellows

Faculty Biographies

Nicolas M Van Mieghem

Nicolas M Van Mieghem

Prof Nicolas Maria Van Mieghem is an Interventional cardiologist at Thoraxcenter, Erasmus MC, Rotterdam, NL decided to pursue a career that would help others. “I enjoy the feeling of being able to help someone or do something important for them". His father was a general cardiologist and one of his biggest influences early in his career.

Prof Van Mieghem initially intended to train as a cardiac surgeon but decided to specialise in interventional cardiology instead, following advice from a mentor. This decision was cemented when he read the first-in-human case report of transcatheter aortic valve implantation (TAVI) in Circulation by Alain Cribier in 2002. Prof Van Mieghem believes that great cardiologist genuinely cares for their patients. He names Gary Roubin, Dr Manu Malbrain and Professor Patrick Serruys among his mentors. 

His current research focuses on cerebral embolic protection during TAVI and the search for improved large bore closure devices. He works actively in expanding TAVI indications, most notably TAVI as a means to further unload the left ventricle in heart failure patients with moderate aortic stenosis (the TAVR UNLOAD trial). Prof Van Mieghem is also involved in the development and dispersion of mechanical circulatory support (MCS) devices as well as transcatheter mitral and tricuspid repair techniques. In terms of imaging and preprocedural planning, his research has covered computed tomography (CT)-derived 3D modelling and printing.

As well as his involvement in percutaneous coronary interventions and structural heart programs, he has published and co-authored over 350 scientific papers in peer-reviewed journals. Professor Van Mieghem is a principal investigator and steering committee member in multiple ongoing international trials, evaluating various coronary and transcatheter valve technologies. He is a Fellow of the European Society of Cardiology (FESC) and is currently Medical Director of the department of Interventional cardiology at the Thorax Centre.

 Prof Van Mieghem is on the ICR3 Editorial Board.


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