Outcomes of a Dedicated Transcatheter Aortic Valve Implantation Device in Patients with Symptomatic Aortic Regurgitation and Prior Cardiac Surgery

All articles of this category (opens in new window) Background: Transcatheter aortic valve implantation (TAVI) is emerging as a promising interventional therapy for severe aortic regurgitation (AR) in selected high-risk patients. This study evaluated the performance of a dedicated transcatheter heart valve (THV) in patients receiving TAVI for native pure noncalcified AR at prohibitive risk for reoperation. Methods: This single-center observational study included 10 consecutive patients with severe AR and prior cardiac surgery who underwent transfemoral TAVI using the JenaValve Trilogy system (JenaValve Technology, Irvine, CA). All cases were deemed at prohibitive surgical risk by the local heart team. Results: Median age was 67 years (IQR, 62–73), and 60% were male. The annular perimeter was 79.7 mm (IQR, 74.5–82.1), the mean transvalvular pressure gradient was 7.5 mmHg (IQR, 6.2–9.5), and the left ventricular ejection fraction was 54.0% (IQR, 50.5–55.0). Valve sizes used were 23/25/27 mm in 5/1/4 patients (50/10/40%). Conscious sedation or local anesthesia was applied in 50% of procedures. Median procedure time was 88.5 minutes (IQR, 78.0–110.0), and median contrast volume was 210 mL (IQR, 160.0–280.0). Technical success was achieved in all cases according to VARC-3 criteria, with no conversions to surgery. Median length of stay was 5 days (IQR, 4–13). At discharge, one echocardiogram was not available. Paravalvular leakage was none or trace in eight patients (89%) and mild in one patient (11%); the mean transvalvular pressure gradient was 4.0 mmHg (IQR, 3.5–6.0). After exclusion of the four patients with prior pacemaker implantation, one of six patients (17%) required a new permanent pacemaker. No patient had a stroke, and one patient had a minor vascular access complication. Mortality at 30 days was 0%. One patient and prior left ventricular assist device implantation, died 53 days after the procedure. Conclusion: In this single-center experience, the use of a dedicated THV for TAVI in patients with AR and after prior cardiac surgery demonstrated high technical success rates and favorable in-hospital outcomes, supporting its role as a promising therapeutic option for severe AR in prohibitive surgical risk patients. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany