Transcatheter Aortic Valve Replacement for Severe Aortic Regurgitation in a Young Adult With Takayasu Arteritis: A Case Report.

Takayasu arteritis (TAK) is a rare large-vessel vasculitis that can cause severe aortic regurgitation (AR) and heart failure in young adults. While surgical aortic valve replacement remains the standard treatment, transcatheter aortic valve replacement (TAVR) has emerged as a viable alternative in high-risk patients. We present the case of a 23-year-old woman with juvenile idiopathic arthritis (JIA) and TAK who developed refractory heart failure secondary to severe AR. Initial echocardiography revealed a left ventricular ejection fraction (LVEF) of 40%. Given active vasculitis, prohibitive surgical risk, and acute decompensation despite medical therapy, emergent TAVR was performed. The patient demonstrated remarkable clinical improvement with LVEF normalization to 56% at one-year follow-up. This case illustrates that TAVR can be successfully performed for severe AR in young adults with TAK when surgical risk is prohibitive, emphasizing the importance of aggressive perioperative inflammation control, multidisciplinary care, and individualized treatment strategies in vasculitis-associated valvular disease.