Ryan Markham1, M Ghodsian2, R Sharma3. 1. Department of Cardiology, Stanford University, 300 Pasteur Drive, 3rd Floor, Room A31, Stanford, CA, 94305, USA. 2. Department of Cardiology, Wollongong Hospital, Loftus St, Wollongong, NSW, 2500, Australia. 3. Department of Cardiology, Stanford University, 300 Pasteur Drive, 3rd Floor, Room A31, Stanford, CA, 94305, USA. rpsharma@stanford.edu.
Abstract
PURPOSE OF THE REVIEW: Moderate or severe aortic regurgitation (AR) occurs in 0.5% of the population and typically peaks in the fourth to sixth decade of life. A significant proportion of patients have prohibitive surgical risk and are therefore treated medically with pharmacological management of heart failure and no definitive treatment of the underlying valvular pathology. RECENT FINDINGS: Transcatheter aortic valve replacement (TAVR) has been used in an off-label setting to treat AR to attempt to reduce mortality and improve quality of life with varying levels of success. New-generation TAVR devices currently used in AS have demonstrated safety and feasibility when used in patients with AR. Novel TAVR devices dedicated for use in AR are being developed and early studies demonstrate promising results. Ongoing studies with larger clinical trials and novel methods of device anchoring are required, which if positive, will in turn lead to commercial approval and reimbursement, eventually making TAVR ready for use in AR.
PURPOSE OF THE REVIEW: Moderate or severe aortic regurgitation (AR) occurs in 0.5% of the population and typically peaks in the fourth to sixth decade of life. A significant proportion of patients have prohibitive surgical risk and are therefore treated medically with pharmacological management of heart failure and no definitive treatment of the underlying valvular pathology. RECENT FINDINGS: Transcatheter aortic valve replacement (TAVR) has been used in an off-label setting to treat AR to attempt to reduce mortality and improve quality of life with varying levels of success. New-generation TAVR devices currently used in AS have demonstrated safety and feasibility when used in patients with AR. Novel TAVR devices dedicated for use in AR are being developed and early studies demonstrate promising results. Ongoing studies with larger clinical trials and novel methods of device anchoring are required, which if positive, will in turn lead to commercial approval and reimbursement, eventually making TAVR ready for use in AR.
Authors: Jack Hartnett; Lisa Brandon; Deirdre Waterhouse; Ross T Murphy; Kevin P Walsh; Mark S Spence; Andrew O Maree Journal: Eur Heart J Case Rep Date: 2021-10-05