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CC BY 4.0 · Aorta (Stamford) 2021; 09(02): 056-059
DOI: 10.1055/s-0041-1725122
State-of-the-Art Review

Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation: Challenging Pathology Awaiting Specialized Devices

Adam El-Gamel 
1   Cardiothoracic Unit, Waikato Hospital, Hamilton, New Zealand
2   Department of Surgery, The University of Auckland, Auckland, New Zealand
3   Medical Reseach Department, Waikato University, New Zealand
› Author Affiliations Funding None.
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Abstract

Patients with aortic incompetence frequently present with anatomical and pathological challenges such as elliptical dilated annulus, dilated aortic root, dilated ascending aorta, and with no calcification in the aortic cusps or annulus. Patients are commonly in graver clinical condition as a result of a long silent clinical course before overt congestive heart failure. All of the above make transcatheter therapies for native aortic valve regurgitation more challenging with poorer outcomes, escalating the risk of insufficient anchoring, prosthesis migration, and residual paravalvular leak compared with current transcatheter aortic valve replacement (TAVR) outcomes for aortic stenosis. There is a need for specialized TAVR devices to address this complex pathology. Surgical aortic valve replacement is the current treatment option and the gold standard for patients with aortic incompetence (AR). Currently, the specific off-label indication for TAVR in pure native AR could be a feasible and reasonable option, as a compassionate treatment is limited to inoperable patients and agreed on by the heart team.

Keywords

pure native aortic incompetence - TAVR for aortic incompetence - surgical aortic valve replacement


Publication History

Received: 23 March 2020

Accepted: 11 November 2020

Article published online:
07 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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