Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation

Abstract

BACKGROUND Limited data exist about safety and efficacy of transcatheter aortic valve replacement (TAVR) in patients with pure native aortic regurgitation (AR).OBJECTIVES This study sought to compare the outcomes of TAVR with early-and new-generation devices in symptomatic patients with pure native AR.METHODS From the pure native AR TAVR multicenter registry, procedural and clinical outcomes were assessed according to VARC-2 criteria and compared between early-and new-generation devices.RESULTS A total of 331 patients with a mean STS score of 6.7 +/- 6.7 underwent TAVR. The early-and new-generation devices were used in 119 patients (36.0%) and 212 patients (64.0%), respectively. STS score tended to be lower in the new-generation device group (6.2 +/- 6.7 vs. 7.6 +/- 6.7; p = 0.08), but transfemoral access was more frequently used in the early-generation device group (87.4% vs. 60.8%; p = moderate (4.2% vs. 18.8%; p= moderate compared with those with post-procedural AR = moderate was independently associated with 1-year all-cause mortality (hazard ratio: 2.85; 95% confidence interval: 1.52 to 5.35; p = 0.001).CONCLUSIONS Compared with the early-generation devices, TAVR using the new-generation devices was associated with improved procedural outcomes in treating patients with pure native AR. In patients with pure native AR, significant post-procedural AR was independently associated with increased mortality. (C) 2017 by the American College of Cardiology Foundation.