TAVI for aortic regurgitation using dedicated devices. A systematic review

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation presents challenges like device anchoring issues and paravalvular regurgitation (PVR).
• Specialized devices have been developed to address these specific challenges in TAVI for aortic regurgitation.

Purpose of the Study:

• To systematically review the safety and efficacy of TAVI using specifically designed devices for pure aortic regurgitation.
• To evaluate outcomes associated with different TAVI devices and access routes in this patient population.

Main Methods:

• A comprehensive literature search was conducted across major databases and conference archives up to April 2024.
• Fifteen observational studies involving 788 patients treated with J-Valve or JenaValve for pure aortic regurgitation were included in the meta-analysis.

Main Results:

• Overall procedural success was high (95.9%), with low rates of surgical conversion (1.8%) and device embolization (3.2%).
• Thirty-day survival was 95.5%, with mild PVR in 18.0% and moderate-to-severe PVR in 1.7%. Permanent pacemaker implantation (PPI) was required in 13.0% of patients.
• The transfemoral approach, primarily with JenaValve, demonstrated high procedural (97.8%) and device success (97.0%), with low moderate-to-severe PVR (0.47%) but a higher PPI rate (18.7%).

Conclusions:

• TAVI using J-Valve and JenaValve is safe and effective for pure aortic regurgitation, particularly with the transfemoral approach.
• Favorable early outcomes were observed, but the frequent need for permanent pacemaker implantation warrants further attention.