Transcatheter Aortic Valve Replacement for Aortic Insufficiency

Transcatheter aortic valve replacement (TAVR) has developed into a viable treatment for aortic regurgitation (AR), particularly in high-risk or elderly patients unable to undergo surgery. Early generation devices encountered significant challenges, including high mortality rates, residual paravalvular leaks, and complications such as valve embolisation. However, advancements in TAVR technology, including self-expanding and balloon-expandable devices, have improved procedural outcomes. Dedicated devices, such as the Trilogy system (JenaValve) and J-Valve (Edwards Lifesciences), specifically designed for AR, have demonstrated superior performance with reduced complications and better patient survival. Other devices, such as Cusper (Cuspa) and the Zeta/Alpha systems (Laguna Tech), show potential for treating complex AR cases, including those with non-calcified valves or active endocarditis. These innovations offer hope for patients with severe AR, highlighting the need for tailored approaches based on individual anatomical and pathological variations.