Key result
TAVI shows feasibility and efficacy for severe AR after aortic dissection and prior complex repairs.
Why the study?
TAVI is generally contraindicated in severe aortic regurgitation with complex anatomy like prior aortic dissection or graft replacement, but may be considered in selected patients.
Is transcatheter aortic valve implantation (TAVI) feasible and effective in a patient with severe aortic regurgitation and complex aortic pathology including prior dissection and endovascular repair?
Is transcatheter aortic valve implantation (TAVI) feasible and effective in a patient with severe aortic regurgitation and complex aortic pathology including prior dissection and endovascular repair?
TAVI may be a feasible and effective treatment option for severe aortic regurgitation even in anatomically extreme post-dissection scenarios with prior aortic graft replacement, provided there is careful heart team evaluation and planning.
May be considered post-heart team review in severe AR with complex aortic repairs; extends TAVI feasibility but remains hypothesis-generating.
Transcatheter aortic valve implantation (TAVI) is generally contraindicated in patients with severe aortic regurgitation associated with anatomically complex scenarios such as prior aortic dissection and/or aortic graft replacement. However, it may be considered in selected patients following heart team evaluation and optimal procedure planning. We report the case of an 81-year-old man with severe aortic regurgitation (AR) who had previously undergone ascending aorta replacement and aorto-bisiliac endovascular aneurysm repair (EVAR) in two consecutive procedures, due to an acute aortic dissection extending from the sinotubular junction to the iliac bifurcation. This case highlights the feasibility and efficacy of TAVI in anatomically extreme post-dissection scenarios, underscoring the importance of individualized decision-making and detailed pre-procedural planning.
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Mazzi et al. (2026) studied this question. Transcatheter aortic valve implantation (TAVI) was feasible and effective in an 81-year-old with severe aortic regurgitation after aortic dissection and prior complex aortic repairs.
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