Key result
NCPI-plus technique achieves stable TAVR anchoring and zero regurgitation at 12 months in severe AR.
Why the study?
TAVR for pure aortic regurgitation with an enlarged LVOT remains challenging due to inadequate anchoring and limited specific guideline recommendations.
Does the NCPI-plus technique provide stable anchoring for TAVR in a patient with pure aortic regurgitation and an enlarged LVOT?
Case Report (n=1)
No
Does the NCPI-plus technique provide stable anchoring for TAVR in a patient with pure aortic regurgitation and an enlarged LVOT?
The NCPI-plus technique offers a feasible and safe anchoring strategy for TAVR in patients with pure aortic regurgitation and enlarged LVOT.
Answers are grounded in this paper and cite their sources.
Should not yet change TAVR practice in pure AR; leaves open need for prospective validation of NCPI-plus durability.
BACKGROUND: Transcatheter aortic valve replacement (TAVR) for pure aortic regurgitation (PAR) with an enlarged left ventricular outflow tract (LVOT) remains challenging due to inadequate anchoring. CASE SUMMARY: A 74-year-old woman with severe PAR and an enlarged LVOT (perimeter 93.7 mm), deemed high risk for surgery, underwent TAVR using a 30-mm self-expanding valve. A modified noncoronary sinus pivot implantation (NCPI-plus) technique was performed, deploying the valve above the virtual annular plane on the noncoronary sinus side to create a supra-annular pivot point. Postprocedural imaging and 12-month follow-up confirmed stable anchoring and excellent valve function without regurgitation. DISCUSSION: The NCPI-plus technique provides stable anchoring for TAVR in PAR patients with dilated LVOT, by using the supra-annular pivot point on the noncoronary sinus side as its core design to prevent downward valve displacement during deployment. TAKE-HOME MESSAGE: The NCPI-plus technique offers a feasible anchoring strategy for TAVR in PAR patients with enlarged LVOT.
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Zhang et al. (2026) conducted a case report in Severe pure aortic regurgitation (PAR) with an enlarged left ventricular outflow tract (LVOT) (n=1). Modified noncoronary sinus pivot implantation (NCPI-plus) technique for TAVR was evaluated on Stable anchoring and valve function without regurgitation. The NCPI-plus technique provided stable anchoring and excellent valve function with no regurgitation at 12 months in a patient with severe pure aortic regurgitation and an enlarged LVOT.
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