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September 12, 2026Circulation Cardiovascular Interventions0 citations

Clinical Outcomes of a Dedicated TAVR Device for Native Aortic Regurgitation: Insights From a Multicenter Real-World Experience

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HWHendrik WienemannInterventional CardiologySYSara YousefzadaHeart and Diabetes Center North Rhine-WestphaliaMRMarc Adrian RogmannJohannes Gutenberg University Mainz

Key Result

Transfemoral TAVR with the Trilogy valve achieved a 98% technical success rate and 0.3% in-hospital mortality in patients with symptomatic aortic regurgitation.

Key Points

  • To evaluate procedural characteristics and clinical outcomes in patients with symptomatic native aortic regurgitation undergoing transfemoral transcatheter aortic valve replacement with the Trilogy valve.
  • Multicenter retrospective analysis of consecutive patients (N=363) treated with the JenaValve Trilogy system between June 2021 and June 2025 at 8 European centers.
  • Clinical and procedural endpoints were evaluated according to Valve Academic Research Consortium-3 (VARC-3) criteria.
  • Technical success reached 98% with transfemoral access utilized in 99% (359/363) of patients; valve embolization occurred in 5 patients, and in-hospital mortality was 0.3%.
  • At discharge, 86% of patients had none or trace aortic regurgitation with a mean transvalvular gradient of 4 mm Hg, and 22% required permanent pacemaker implantation.
  • Kaplan-Meier estimated all-cause mortality was 4.1% at 6 months, 7.0% at 1 year, 15.8% at 2 years, and 25.9% at 3 years, with 88% achieving NYHA functional class I or II at 30 days.

Study Design

Type

Cohort (n=363)

Multicenter

Yes

Structured PICO

P
Population
363 patients (median age 81, 45% female) with symptomatic aortic regurgitation undergoing transfemoral TAVR with the Trilogy valve, followed for up to 3 years.
E
Exposure
Transcatheter aortic valve replacement (TAVR) with the JenaValve Trilogy Transcatheter Heart Valve System (99% transfemoral access).
O
Outcome
Procedural characteristics and clinical outcomes defined per VARC-3 (Valve Academic Research Consortium-3).hard clinical

In a real-world multicenter cohort, TAVR with the dedicated JenaValve Trilogy device for symptomatic native aortic regurgitation demonstrated high technical success (98%) and low early mortality, supporting its potential role in patients unsuitable for surgery.

Abstract

BACKGROUND: The JenaValve Trilogy Transcatheter Heart Valve System (Trilogy) is a CE-marked transcatheter aortic valve replacement device designed for the treatment of symptomatic aortic regurgitation. Despite its unique indication, data from large cohorts remain limited. This study aimed to evaluate procedural characteristics and clinical outcomes in all-comers patients with symptomatic aortic regurgitation undergoing transfemoral transcatheter aortic valve replacement with the Trilogy valve. METHODS: This multicenter retrospective analysis included patients with symptomatic aortic regurgitation who underwent Trilogy implantation between June 2021 and June 2025 at 8 European centers. Baseline, procedural, and follow-up data were collected according to local protocols, and outcomes were defined per VARC-3 (Valve Academic Research Consortium-3). RESULTS: A total of 363 patients (median age, 81 years interquartile range, 75-84; 45% female patients; median European System for Cardiac Operative Risk Evaluation II, 3.4%; median left ventricular ejection fraction, 50%) were included. Transfemoral access was used in 359 (99%), and technical success was achieved in 98%. Valve embolization occurred in 5 patients: 2 managed with a second valve, 2 surgically, and 1 required valve-in-valve reintervention. Two additional technical failures involved hemodynamic instability and a vascular complication. At discharge, 86% had none or trace leakage, and the mean transvalvular gradient was 4 mm Hg. Permanent pacemaker implantation was required in 22%. In-hospital mortality was 0.3%. At 30 days, functional status had improved markedly, with 88% of patients in New York Heart Association class I or II. Kaplan-Meier estimated all-cause mortality at 6 months, 1, 2, and 3 years was 4.1%, 7.0%, 15.8%, and 25.9%, respectively, among patients with available follow-up. CONCLUSIONS: In this large analysis, transfemoral transcatheter aortic valve replacement with the Trilogy valve demonstrated high procedural success and favorable hemodynamic valve performance. These findings are encouraging and suggest a potential role for the Trilogy valve in patients with symptomatic aortic regurgitation who are unsuitable for surgery.

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Cite This Study

Wienemann et al. (2026) conducted a cohort in symptomatic aortic regurgitation (n=363). Trilogy valve was evaluated on Technical success. Transfemoral TAVR with the Trilogy valve achieved a 98% technical success rate and 0.3% in-hospital mortality in patients with symptomatic aortic regurgitation.

synapsesocial.com/papers/6aa51f39327956e4761f97eehttps://doi.org/10.1161/circinterventions.126.016851
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