AIM   To investigate the clinical efficacy and preoperative evaluation of transcatheter aortic valve replacement (TAVR) in the treatment of bicuspid aortic stenosis.

  METHODS   A total of 54 TAVR patients in Fuwai Hospital from January 2020 to December 2020 were retrospectively analyzed for morphological characteristics of aortic root and the effectiveness and safety of operation.

  RESULTS   The oversize of valve selection for trilobal valve group, functional BAV group and anatomical BAV group was respectively −0.22 ± 8.62 vs. 0.53 ± 8.37 vs. 8.02 ± 6.71. The mean diameter of annulus, outflow tract, sinus junction and ascending aorta measured by 3mensio were significantly different between the three groups (P < 0.01). There was significant difference in the opening height of left and right crowns between the three groups (P < 0.05). There were no significant differences between the three groups in terms of conversion to surgery, intraoperative valve reimplantation, intraoperative cardiopulmonary bypass, intraoperative left ventricular rupture, postoperative ECMO, postoperative peripheral vascular complications, postoperative disabling stroke, death, postoperative pacemaker implantation and postoperative coronary embolism.

  CONCLUSION   Transcatheter aortic valve replacement is safe and effective in the treatment of bicuspid aortic tenosis. Preoperative CT evaluation is of great significance. Downsize is recommended for valve selection of BAV and downsize to a large extent is recommended for anatomic BAV