JACC. Case reports · 2025
Extreme Anchoring: Self-Expanding Valve TAVR for Severe Pure Aortic Regurgitation in Sinus of Valsalva Aneurysm.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Chen Xinjing, Guo Yansong, Hong Jingxuan, Fang Mingcheng, Liu Xianbao
Аннотация
BACKGROUND: Transcatheter aortic valve replacement (TAVR) for pure aortic regurgitation (PAR) remains technically challenging because of the lack of calcified annular structures for device anchoring.
CASE SUMMARY: We report successful noncoronary sinus pivot implantation (NCPI) of a 29-mm self-expanding valve in a high-risk PAR patient (Society of Thoracic Surgeons 8.2%) with extreme root dilatation and no calcification under the STABLE protocol. Post-procedure imaging confirmed hemodynamic success, no paravalvular leak, ventricular recovery, and optimal root remodeling.
DISCUSSION: This case highlights the role of annular-subannular anchoring (NCPI technique) and multimodality imaging in TAVR PAR with sinus of Valsalva aneurysm, addressing migration risks and expanding procedural feasibility beyond calcific stenosis-a critical advancement in an understudied population.
TAKE-HOME MESSAGE: Self-expanding TAVR using anatomy-tailored anchoring (eg, NCPI) is viable in PAR with complex root anatomy, requiring imaging-guided precision for stable deployment and functional recovery.
CASE SUMMARY: We report successful noncoronary sinus pivot implantation (NCPI) of a 29-mm self-expanding valve in a high-risk PAR patient (Society of Thoracic Surgeons 8.2%) with extreme root dilatation and no calcification under the STABLE protocol. Post-procedure imaging confirmed hemodynamic success, no paravalvular leak, ventricular recovery, and optimal root remodeling.
DISCUSSION: This case highlights the role of annular-subannular anchoring (NCPI technique) and multimodality imaging in TAVR PAR with sinus of Valsalva aneurysm, addressing migration risks and expanding procedural feasibility beyond calcific stenosis-a critical advancement in an understudied population.
TAKE-HOME MESSAGE: Self-expanding TAVR using anatomy-tailored anchoring (eg, NCPI) is viable in PAR with complex root anatomy, requiring imaging-guided precision for stable deployment and functional recovery.