Transcatheter Management of Pure Native Aortic Valve Regurgitation in Patients With Left Ventricular Assist Device

Aortic valve regurgitation (AR) often occurs after left ventricular assist device (LVAD) implantation. Transcatheter aortic valve implantation (TAVI) is a viable alternative to surgical aortic valve replacement (SAVR) in this cohort, most of whom have a high surgical risk profile. Procedure outcome and survival were analyzed. From 2017 to 2023, 27 LVAD patients with significant AR received elective or urgent TAVI at this center. Of these patients, 25 percent had device landing zone pre-stenting followed by a standard TAVI device and 59 percent received standard TAVI devices, with 37 percent of these patients requiring a second transcatheter heart valve (THV). Aortic regurgitation in more than trace amounts affected 6 percent of patients at discharge. Fifteen percent received AR-dedicated TAVI devices, with none requiring a second THV and no AR at discharge. TAVI has promising outcomes and survival in LVAD patients, with tailored devices and pre-stenting enhancing procedure success.