Experience in transcatheter aortic valve replacement for isolated aortic regurgitation in patients with oversized annulus
LI Yue-huan
ZHOU Jia-wei
LUO Tian-ge
CHEN Zhang
LI Hao-yang
SHEN Jing-lun
WU Kai-sheng
WANG Jian-gang
ZHANG Hai-bo
Abstract：Objective To summarize the experience in the innovative application of the J-Valve system,including stent widening and/or the safety cord technique,for successful transcatheter aortic valve replacement(TAVR)in patients with oversized annular diameters.Methods The patients who underwent TAVR at the Center for Valve and Atrial Fibrillation Surgery,Beijing Anzhen Hospital,Capital Medical University between April 2018 and September 2023 were included.These patients had severe aortic regurgitation with an aortic annulus diameter＞29 mm and were at high risk or had contraindications for open-heart surgery.Results Modified TAVR with stent widening and/or the safety cord technique was performed in 19 patients with a mean age(65.4±10.9)years with an annular diameter greater than 29 mm.The predicted mortality rates by the society of thoracic surgeons(STS)score and EuroSCORE Ⅱ were 12.4(7.8-17.3)％and(23.3±3.7)％,respectively.The aortic annulus diameter and left ventricular outflow tract diameter were(30.5±1.4)mm and(33.7±5.4)mm,respectively.Impaired left ventricular systolic function was observed,with a left ventricular ejection fraction of(46.1±13.0)％.The left ventricle was significantly enlarged,with the end-diastolic and end-systolic diameters of(67.8±10.5)mm and(54.1±13.0)mm,respectively.All patients were treated with the J-Valve system using a transapical approach.The surgical success rate was 94.7％.The median and maximum follow-up durations were 12(4～41)months and 60 months,respectively.During the follow-up,5 patients died,resulting in an all-cause mortality rate of 29.4％.Conclusions Transapical aortic valve replacement using the J-Valve system,combined with stent widening and/or the safety cord technique,is safe and feasible for treating pure severe aortic regurgitation in patients with a large annulus.
Keywords：Heart valve diseaseAortic regurgitationTransapical aortic valve replacementCardiac insufficiencyLarge annulus
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 310-315 )