One-year outcome after transcatheter aortic valve replacement for aortic regurgitation: A single-center study

J Card Surg. 2022 Apr;37(4):882-892. doi: 10.1111/jocs.16238. Epub 2022 Jan 18.

Abstract

Background: Presently, there are limited reports in the literature on the postoperative (midterm) clinical outcome for pure aortic regurgitation (AR) following transcatheter aortic valve replacement (TAVR).

Methods: Between March 2014 and June 2019, a total of 134 high-risk patients with pure, symptomatic severe AR patients were enrolled in the current study. The outcome was assessed according to the Valve Academic Research Consortium-2 criteria. Procedural results, clinical outcomes, and the patients' hemodynamics for a period of 1 year were analyzed.

Results: The patient mean was 73.1 ± 6.4 years and 25.4% were female. The average Society of Thoracic Surgeons score was 9.8 ± 5.3%. Procedural success was 97.1% (130/134), and the device success rate was 96.3% (129/134). Five cases were converted to open surgery, while two patients underwent valvular reinterventions (surgical aortic valve replacement for thrombosis and increasing paravalvular regurgitation). The mean aortic valve gradient was 10.2 ± 4.1 mmHg, while the moderate and severe AR was 1.6% at 1 year. Paravalvular regurgitation was none/trivial in 79.8% and mild in 18.5%. The 1-year all-cause mortality rate was 7.4%. At 1 year, the stroke incidence rate was 2.2%, and a pacemaker was implanted in 8.9% of the enrolled patients.

Conclusions: In high-risk patients undergoing transapical TAVR for AR, the use of the J-Valve is safe, and effective TAVR should be considered as a reasonable option for high-risk patients with pure AR.

Keywords: J-Valve® system; aortic regurgitation/insufficiency; transcatheter aortic valve implantation.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Insufficiency* / etiology
  • Aortic Valve Stenosis* / surgery
  • Female
  • Heart Valve Prosthesis*
  • Humans
  • Prosthesis Design
  • Risk Factors
  • Time Factors
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome