TAVR in Pure Aortic Regurgitation Is Associated with Lower Mortality Rates

This study summarizes all available evidence on transcatheter aortic valve replacement (TAVR) for the treatment of native pure aortic regurgitation.

Surgical replacement is the standard of care for pure aortic regurgitation. However, there are many reports of cases and small studies in which high-risk patients with pure aortic regurgitation were treated with TAVR.

Authors systematically searched for works reporting at least 5 patients with pure aortic regurgitation who received TAVR. The primary endpoint was all-cause mortality.

The analysis included 13 works, which amounted a total of 237 patients. Most of them received self-expandable prostheses (79%).

Procedural success ranged between 74% and 100%, and 17 patients (7%) required the implantation of a second valve. Conversion to conventional surgery was 2.5%.

The rate of all-cause mortality at 30 days was 7% (95% confidence interval [CI]: 3% to 13%). There were no cerebrovascular events and major bleeding and vascular complication rates were 2% and 3%, respectively.

Permanent pacemaker implantation was required in 11% of patients, a relatively low rate if we take into account that self-expandable prostheses were used in most patients.

The rate of moderate to severe procedural aortic regurgitation was 9%.

Conclusion

In selected patients with pure aortic regurgitation who were not eligible for conventional surgery due to high risk, transcatheter replacement is feasible and associated with an acceptable short-term mortality rate.

Original title: Transcatheter Aortic Valve Replacement for the Treatment of Pure Native Aortic Valve Regurgitation. A Systematic Review.

Reference: Anna Franzone et al. J Am Coll Cardiol Intv. 2016. ONLINE FIRST.

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