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Transcatheter Aortic Valve Replacement for Treating Native Aortic Regurgitation: Ready for Prime Time?
Raviteja R Guddeti1, Nadia El-Hangouche2, Geoffrey Answini3
1Division of Interventional Cardiology, The Carl and Edyth Lindner Research Center at the Christ Hospital, Cincinnati, Ohio, USA.
Structural Heart : the Journal of the Heart Team
|October 31, 2025
Summary
Transcatheter aortic valve replacement (TAVR) is not recommended for severe aortic regurgitation (AR) using current devices. Dedicated transcatheter heart valves (THVs) show promise for improved outcomes in patients unsuitable for surgery.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Severe aortic regurgitation (AR) is linked to increased mortality.
- Surgical aortic valve replacement is the standard, but many patients are inoperable.
- Transcatheter options are needed for this high-risk population.
Purpose of the Study:
- To review the challenges and evolving landscape of transcatheter aortic valve replacement (TAVR) for severe aortic regurgitation (AR).
- To highlight the limitations of current transcatheter heart valves (THVs) in AR and the potential of dedicated devices.
Main Methods:
- Review of current literature on TAVR for AR.
- Analysis of off-label TAVR device use and dedicated THV systems (JenaValve, J-Valve).
- Discussion of anatomical challenges and preliminary clinical evidence.
Main Results:
- Off-label TAVR for AR has shown suboptimal results, including valve embolization and residual AR.
- Anatomical factors like large annuli and dilated aortic roots hinder device anchoring.
- Dedicated THVs (JenaValve, J-Valve) show promising short-term results in early trials.
Conclusions:
- There is a significant unmet need for effective transcatheter therapies for severe AR.
- Dedicated THVs like JenaValve and J-Valve are under investigation and may offer improved outcomes.
- Further clinical trials are essential before regulatory approval for these dedicated AR devices.
Keywords:
Aortic regurgitationCardiac magnetic resonance imagingEchocardiographySurgical aortic valve replacementTranscatheter aortic valve replacementTranscatheter heart valveMore Related Videos
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