Treatment Of Pure Aortic Regurgitation Using A Novel Second Generation Transcatheter Aortic Valve Implantation System Real World Experience
Yingqiang Guo1, Da Zhu1, Lai Wei2, Chunsheng Wang2, Wei Wang3, Xin Wang3.
1West China hospital of Sichuan University, Chengdu, China, 2Zhongshan Hospital，Fudan University, Chengdu, China, 3Fuwai Hospital, Chengdu, China.
Background: Experience with transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation (AR) is limited due to the risk of insufficient anchoring of the valve stent within the non-calcified aortic annulus. The aim of this study is to report the clinical experience with a novel transcatheter aortic valve implantation system, the J-Valve system for the treatment of pure AR. Method: Transapical TAVI with the J-Valve system was performed in 58 patients with pure AR with a mean age of 72.3 ± 5.7 years including 39 male. All patients were considered high risk for open-heart surgery with a mean logistic Euro-SCORE 20.1 ± 3.3%. Clinical and echocardiographic evaluations were performed at baseline, post-procedure and follow-up. Procedural success and complications were reported according to VARC-2 (Valve Academic Research Consortium) definitions. Result: Implantation was successful in 56 of 58 cases (success rate 96.6%). All cause mortality was 5.2% during follow-up with median follow-up 2 years. Two patients were converted to surgical valve replacement due to moderate degree PVL after valve implantation and valve embolism. Pacemaker implantation for new onset third degree AV block was necessary in 3 patients (5.2%). Minor access complication was noted in 4 patients (6.9%). Post-procedural paravalvular leakage was none/trace in 81.1% (43/53) and mild in 18.9% (10/53) among study cohort at follow-up. Mean transvalvular gradient was favorable after valve implantation during follow-up at 9.5±4.5 mmHg. Conclusion: Pure AR remains a challenging pathology and unmet need as for TAVI procedure. The J-Valve system demonstrated feasibility, safety and effectiveness in the treatment of patients with pure AR.
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