TAVI for aortic regurgitation using dedicated devices. A systematic review
ABSTRACT Introduction and objectives: Transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation is challenging due to inadequate device anchoring and increased risks of device embolization and paravalvular regurgitation (PVR). This study aimed to review the safety and efficacy of...
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2025-02-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
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| author | Ahmed Hassan Mahmoud Abdelshafy Rehab Adel Diab Hendrik Wienemann Matti Adam Santiago García Marwan Saad Mohammad Abdelghani |
| author_facet | Ahmed Hassan Mahmoud Abdelshafy Rehab Adel Diab Hendrik Wienemann Matti Adam Santiago García Marwan Saad Mohammad Abdelghani |
| author_sort | Ahmed Hassan |
| collection | DOAJ |
| description | ABSTRACT Introduction and objectives: Transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation is challenging due to inadequate device anchoring and increased risks of device embolization and paravalvular regurgitation (PVR). This study aimed to review the safety and efficacy of TAVI for aortic regurgitation with devices specifically designed for this indication. Methods: A comprehensive search of PubMed, Web of Science, Cochrane Library, and major conference archives up to April 2024 identified 143 unique results based on predefined criteria. Results: Fifteen studies (n = 788 patients) were included, with J-Valve used in 357 patients and JenaValve in 431. Men represented 51% of the cohort, with a mean age of 74.7 ± 8.8 years and an STS-PROM score of 5.8 ± 4.9%. Transapical and transfemoral access routes were used in 62.7% and 37.3% of patients, respectively. Overall, procedural success was achieved in 95.9% of cases; surgical conversion was required in 1.8%, device migration/embolization occurred in 3.2%, and a second valve (in-valve) was required in 2.0% of patients. At 30 days, 95.5% of patients were alive, and device success was reported in 93.3% of cases. Mild PVR was observed in 18.0% of patients, moderate-to-severe PVR in 1.7%, and permanent pacemaker implantation (PPI) was required in 13.0%. In studies focusing on transfemoral procedures (all using JenaValve), the pooled estimates showed a procedural success rate of 97.8% (95%CI, 94.4-100), device success of 97.0% (95%CI, 94.8-99.2), 30-day mortality of 1.96% (95%CI, 0.20-3.72), moderate-to-severe PVR of 0.47% (95%CI, 0.00-1.47), and PPI requirement of 18.7% (95%CI, 13.9-23.4) Conclusions: This systematic review of relatively small observational studies demonstrates the safety and favorable early outcomes of TAVI using J-Valve and JenaValve in patients with pure aortic regurgitation, especially when the transfemoral approach is used. Nevertheless, the need for PPI remains frequent. |
| format | Article |
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| publishDate | 2025-02-01 |
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| spelling | doaj-art-c9a2ec6c996e4f5fbb46bddfc86a92cb2025-08-20T02:13:32ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222025-02-0171294310.24875/RECICE.M24000477TAVI for aortic regurgitation using dedicated devices. A systematic reviewAhmed Hassan0Mahmoud Abdelshafy1Rehab Adel Diab2Hendrik Wienemann3Matti Adam4Santiago García5Marwan Saad6Mohammad Abdelghani7Department of Cardiology, Suez Medical Complex, Suez, EgyptCardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Department of Cardiology, University of Galway, Galway, IrelandCardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, EgyptClinic III for Internal Medicine, University Hospital Cologne, Cologne, GermanyClinic III for Internal Medicine, University Hospital Cologne, Cologne, GermanyDivision of Cardiology, The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, United StatesInterventional structural heart research, Lifespan Cardiovascular Institute and Warren Alpert Medical School, Brown University, Providence, United StatesCardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Cardiology Unit, Department of Internal Medicine, Sohar Hospital, Sohar, OmanABSTRACT Introduction and objectives: Transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation is challenging due to inadequate device anchoring and increased risks of device embolization and paravalvular regurgitation (PVR). This study aimed to review the safety and efficacy of TAVI for aortic regurgitation with devices specifically designed for this indication. Methods: A comprehensive search of PubMed, Web of Science, Cochrane Library, and major conference archives up to April 2024 identified 143 unique results based on predefined criteria. Results: Fifteen studies (n = 788 patients) were included, with J-Valve used in 357 patients and JenaValve in 431. Men represented 51% of the cohort, with a mean age of 74.7 ± 8.8 years and an STS-PROM score of 5.8 ± 4.9%. Transapical and transfemoral access routes were used in 62.7% and 37.3% of patients, respectively. Overall, procedural success was achieved in 95.9% of cases; surgical conversion was required in 1.8%, device migration/embolization occurred in 3.2%, and a second valve (in-valve) was required in 2.0% of patients. At 30 days, 95.5% of patients were alive, and device success was reported in 93.3% of cases. Mild PVR was observed in 18.0% of patients, moderate-to-severe PVR in 1.7%, and permanent pacemaker implantation (PPI) was required in 13.0%. In studies focusing on transfemoral procedures (all using JenaValve), the pooled estimates showed a procedural success rate of 97.8% (95%CI, 94.4-100), device success of 97.0% (95%CI, 94.8-99.2), 30-day mortality of 1.96% (95%CI, 0.20-3.72), moderate-to-severe PVR of 0.47% (95%CI, 0.00-1.47), and PPI requirement of 18.7% (95%CI, 13.9-23.4) Conclusions: This systematic review of relatively small observational studies demonstrates the safety and favorable early outcomes of TAVI using J-Valve and JenaValve in patients with pure aortic regurgitation, especially when the transfemoral approach is used. Nevertheless, the need for PPI remains frequent.https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=2584Aortic regurgitation Transcatheter aortic valve implantation Outcome Systematic review J-Valve JenaValve |
| spellingShingle | Ahmed Hassan Mahmoud Abdelshafy Rehab Adel Diab Hendrik Wienemann Matti Adam Santiago García Marwan Saad Mohammad Abdelghani TAVI for aortic regurgitation using dedicated devices. A systematic review REC: Interventional Cardiology (English Ed.) Aortic regurgitation Transcatheter aortic valve implantation Outcome Systematic review J-Valve JenaValve |
| title | TAVI for aortic regurgitation using dedicated devices. A systematic review |
| title_full | TAVI for aortic regurgitation using dedicated devices. A systematic review |
| title_fullStr | TAVI for aortic regurgitation using dedicated devices. A systematic review |
| title_full_unstemmed | TAVI for aortic regurgitation using dedicated devices. A systematic review |
| title_short | TAVI for aortic regurgitation using dedicated devices. A systematic review |
| title_sort | tavi for aortic regurgitation using dedicated devices a systematic review |
| topic | Aortic regurgitation Transcatheter aortic valve implantation Outcome Systematic review J-Valve JenaValve |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=2584 |
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