Study Supports Feasibility of TAVI for High-Risk Aortic Regurgitation Interview with:
Anna Franzone, MD and
Prof.Thomas Pilgrim, MD
Department of Cardiology
Bern University Hospital
Bern, Switzerland What is the background for this study? What are the main findings?

Response: Surgical aortic valve replacement is the therapeutic standard for patients with pure native aortic regurgitation (AR). However, transcatheter aortic valve implantation (TAVI) is emerging as a novel treatment option for patients deemed inoperable or at high-risk for surgery because of advanced age and multiple comorbidities. We performed a systematic review and meta-analysis including 237 patients with pure native AR undergoing TAVI across 13 studies. The primary study endpoint, all-cause mortality at 30-day, ranged from 0% up to 30% with a summary estimate rate of 7% . The occurrence of complications such as the need for a second valve implantation was relatively low as well as the rates of other endpoints (cerebrovascular events, major bleeding and vascular complications). What should readers take away from your report?

Response: The results of our study support the technical feasibility of TAVI for the treatment of high-risk patients with acceptable early mortality and low rates of adverse events. What recommendations do you have for future research as a result of this study?

Response: Large studies with longer follow-up are needed to definitely assess the performance of TAVI in patients with pure native AR. Specific anatomic features of pure native AR challenge the adequate positioning and stability of transcatheter heart valves. However, new-generation valve designs using leaflet “pinning” or aortic “docking” have the potential to demonstrate greater efficacy in this condition. Is there anything else you would like to add?

Response: The systematic appraisal of the experience with the off-label use of TAVI devices is of crucial importance for the expansion of its indications. Thank you for your contribution to the community.


Franzone A, Piccolo R, Siontis GM, et al. Transcatheter Aortic Valve Replacement for the Treatment of Pure Native Aortic Valve Regurgitation: A Systematic Review. J Am Coll Cardiol Intv. 2016;():. doi:10.1016/j.jcin.2016.08.049.

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Last Updated on October 28, 2016 by Marie Benz MD FAAD