Transcatheter Aortic Valve Replacement in Pure Native Valve Aortic Regurgitation Using a 35‐mm Balloon‐Expandable Myval XXL Valve and a 24‐French Python BZ Smart Introducer Sheath

Pure aortic regurgitation is the third most common valvular heart disease and is associated with significant morbidity and mortality. Surgical aortic valve replacement remains the standard treatment for symptomatic patients. Transcatheter aortic valve replacement (TAVR) is an alternative for those at high surgical risk; however, its use is limited by higher complication rates and the lack of suitable valve options. Previously, balloon-expandable valves were available only in sizes up to 32 mm, restricting their application in patients with larger aortic annuli. We report the first use of the 35 mm balloon-expandable Myval XXL valve with a long 24 French Python introducer sheath for TAVR in a patient with non-calcific aortic regurgitation and an annular area of 722 mm². This case highlights a potential advancement in TAVR technology, expanding treatment options for patients with non-calcific aortic regurgitation with large annuli previously considered ineligible for TAVR.