Key result
Navitor valve achieves procedural success without significant paravalvular regurgitation in challenging LVOT nodular calcification cases.
Why the study?
Protruding left ventricular outflow tract calcification is a high-risk anatomical feature for TAVR, increasing risk of paravalvular regurgitation, annular injury, and conduction disturbance.
Can the Navitor self-expanding valve system be successfully implanted without significant residual paravalvular regurgitation in patients with severe aortic stenosis and protruding left ventricular outflow tract calcification?
Case Report (n=4)
Can the Navitor self-expanding valve system be successfully implanted without significant residual paravalvular regurgitation in patients with severe aortic stenosis and protruding left ventricular outflow tract calcification?
The Navitor self-expanding valve system may adapt and provide effective sealing in the presence of protruding LVOT calcification, achieving procedural success without moderate-or-greater paravalvular regurgitation in this small case series.
Navitor may be feasible in high-risk LVOT calcification; leaves open need for larger prospective studies.
BACKGROUND: Protruding left ventricular outflow tract calcification represents a high-risk anatomical feature for transcatheter aortic valve replacement, predisposing to paravalvular regurgitation (PVR), annular injury, and conduction disturbance. CASE SUMMARY: We present 4 patients with severe symptomatic aortic stenosis and protruding left ventricular outflow tract calcific nodules treated with the Navitor self-expanding valve system. Despite uniformly hostile landing-zone anatomy, procedural success was achieved in all cases. Residual PVR ranged from trivial to mild-to-moderate, with no patient developing moderate-or-greater PVR. All patients demonstrated hemodynamic improvement and early symptomatic benefit. CONCLUSIONS: Calcific morphology and nodule orientation, rather than calcium burden alone, may be key determinants of PVR following Navitor implantation in hostile landing-zone anatomy. These findings are hypothesis-generating; the observed pattern of adaptive cuff sealing requires verification in larger, preferably comparative studies before conclusions regarding device-specific sealing mechanisms can be drawn.
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Salem et al. (2026) conducted a case report in Severe symptomatic aortic stenosis and protruding left ventricular outflow tract calcific nodules (n=4). Navitor self-expanding valve system was evaluated on Procedural success and residual paravalvular regurgitation (PVR). Treatment with the Navitor self-expanding valve system achieved procedural success in 4 patients with severe aortic stenosis and protruding LVOT calcific nodules, with no moderate-or-greater PVR.
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