Transcatheter Aortic Valve Replacement in Aortic Regurgitation

Evidence about safety and efficacy of transcatheter aortic valve replacement remains limited for patients with aortic regurgitation.

From the Safety and Efficacy of the J-Valve Ausper System in Patients with Severe Aortic Stenosis and/or Aortic Regurgitation Registry, the clinical outcomes of patients with aortic regurgitation from West China Hospital were analyzed.

A total of 134 patients with The Society of Thoracic Surgeons mean risk score of 9.8% underwent transcatheter aortic valve replacement with the J-Valve. Of those, 5 patients (3.7%) were converted to surgical aortic valve replacement. The cumulative all-cause mortality was 3% at 30 days and 3.7% at 6 months. One major bleeding (0.7%), 1 major vascular complication (0.7%), 8 acute kidney diseases (6%), 12 third-degree atrioventricular block (9%), and 1 paravalvular leakage (0.7%) moderate or greater occurred. The device success rate was 96.3%. Mean ejection fraction improved from 52.1% to 57.1% (P < .001) at 30 days and to 58.7% (P < .001 compared with baseline) at 6 months. Mean estimated pulmonary arterial pressure decreased from 29.3 to 23.1 mm Hg (P < .001) at 30 days and to 21.5 mm Hg (P < .001 compared with the baseline) at 6 months. On multivariable analysis, New York Heart Association functional class at 6 months (odds ratio 8.87; 95% confidence interval, 1.36 to 58.06) was independently associated with all-cause mortality at 6 months.

Transcatheter aortic valve replacement with the J-Valve proved to have acceptable early and midterm clinical outcomes for patients with aortic regurgitation. This is a large-scale single-center study to evaluate the safety and efficacy of transcatheter aortic valve replacement in treating aortic regurgitation.