Robin Le Ruz; Lionel Leroux; Thibault Lhermusier; Thomas Cuisset; Eric Van Belle; Alain Dibie; Vincenzo Palermo; Didier Champagnac; Jean-François Obadia; Emmanuel Teiger; Patrick Ohlman; Didier Tchétché; Herve Le Breton; Christophe Saint-Etienne; Pierre-Guillaume Piriou; Julien Plessis; Sylvain Beurtheret; Florence Du  Chayla; Manon Leclère; Thierry Lefèvre; Jean-Philippe Collet; Hélène Eltchaninoff; Martine Gilard; Bernard Iung; Thibaut Manigold; Vincent Letocart; on of STOP-AS and FRANCE-TAVI investigators

doi:10.4244/EIJ-D-24-00339

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

The reference multimedia journal in interventional cardiology

Original Research

DOI: 10.4244/EIJ-D-24-00339

Outcomes of transcatheter aortic valve implantation for native aortic valve regurgitation

Robin Le Ruz¹^,², MD; Lionel Leroux³, MD; Thibault Lhermusier⁴, MD, PhD; Thomas Cuisset⁵, MD, PhD; Eric Van Belle⁶, MD, PhD; Alain Dibie⁷, MD, PhD; Vincenzo Palermo⁸, MD; Didier Champagnac⁹, MD; Jean-François Obadia¹⁰, MD, PhD; Emmanuel Teiger¹¹, MD, PhD; Patrick Ohlman¹², MD, PhD; Didier Tchétché¹³, MD; Hervé Le Breton¹⁴, MD, PhD; Christophe Saint-Etienne¹⁵, MD; Pierre-Guillaume Piriou¹, MD; Julien Plessis¹, MD; Sylvain Beurtheret¹⁶, MD; Florence Du Chayla¹⁷, PhD; Manon Leclère¹⁷, PhD; Thierry Lefèvre¹⁸, MD; Jean-Philippe Collet¹⁹, MD, PhD; Hélène Eltchaninoff²⁰, MD, PhD; Martine Gilard²¹, MD, PhD; Bernard Iung²², MD, PhD; Thibaut Manigold¹, MD; Vincent Letocart¹, MD; on behalf of STOP-AS and FRANCE-TAVI investigators

1. Interventional Cardiology Department, Nantes Université, CHU Nantes, L’institut du thorax, Nantes, France; 2. Nantes Université, CHU Nantes, CNRS, INSERM, L’institut du thorax, Nantes, France; 3. Department of Cardiology and Cardiovascular Surgery, Hôpital Cardiologique de Haut-Lévêque, Pessac, France; 4. Department of Cardiology, Rangueil University Hospital, Toulouse, France; 5. Centre for Cardiovascular and Nutrition Research, Aix Marseille Université, Marseille, France; 6. University of Lille, INSERM, Centre Hospitalier Universitaire Lille, Institut Pasteur de Lille, Lille, France; 7. Institut Mutualiste Montsouris, Paris, France; 8. Hôpital Marie-Lannelongue (groupe hospitalier Paris Saint-Joseph), Le Plessis-Robinson, France; 9. Médipôle Lyon-Villeurbanne, Villeurbanne, France; 10. Clinical Investigation Center & Heart Failure Department, Hôpital Cardiovasculaire Louis Pradel, INSERM 1407, Hospices Civils de Lyon and Claude Bernard University, Lyon, France; 11. Department of Cardiology, APHP, Henri-Mondor University Hospital, Créteil, France; 12. Department of Cardiology, University Hospital of Strasbourg, Strasbourg, France; 13. Clinique Pasteur, Toulouse, France; 14. Department of Cardiology, University of Rennes, CHU Rennes, INSERM, LTSI – UMR 1099, Rennes, France; 15. Centre Hospitalier Régional Universitaire Tours, Tours, France; 16. Saint-Joseph Hospital, Marseille, France; 17. Clinityx, Paris, France; 18. Institut Cardiovasculaire Paris Sud, Hôpital privé Jacques Cartier, Ramsay Santé, Massy, France; 19. ACTION Study Group, Sorbonne Université, UMRS 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France; 20. Department of Cardiology, University Rouen Normandie, INSERM U1096, CHU Rouen, Rouen, France; 21. Department of Cardiology, Brest University Hospital, Brest, France; 22. Department of Cardiology, Université Paris-Cité, Paris, France and Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, Paris, France

Abstract

BACKGROUND: Large datasets of transcatheter aortic valve implantation (TAVI) for pure aortic valve regurgitation (PAVR) are scarce.

AIMS: We aimed to report procedural safety and long-term clinical events (CE) in a contemporary cohort of PAVR patients treated with new-generation devices (NGD).

METHODS: Patients with grade III/IV PAVR enrolled in the FRANCE-TAVI Registry were selected. The primary safety endpoint was technical success (TS) according to Valve Academic Research Consortium 3 criteria. The co-primary endpoint was defined as a composite of mortality, heart failure hospitalisation and valve reintervention at last follow-up.

Results: From 2015 to 2021, 227 individuals (64.3% males, median age 81.0 [interquartile range {IQR} 73.5-85.0] years, with EuroSCORE II 6.0% [IQR 4.0-10.9]) from 41 centres underwent TAVI with NGD, using either self-expanding (55.1%) or balloon-expandable valves (44.9%; p=0.50). TS was 85.5%, with a non-significant trend towards increased TS in high-volume activity centres. A second valve implantation (SVI) was needed in 8.8% of patients, independent of valve type (p=0.82). Device size was ≥29 mm in 73.0% of patients, post-procedure grade ≥III residual aortic regurgitation was rare (1.2%), and the...

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