A case report: Transcatheter aortic valve replacement via femoral artery for aortic regurgitation post-CARVAR

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Recurrent severe aortic regurgitation post-CARVAR (n=1). Intervention: Transcatheter aortic valve replacement (TAVR) with ultra-high release technique. Primary outcome: Procedural success and cardiac function improvement (LVEF) at 3 months.

Lin Li; Zhiming Zhou; Xiaoyu Wang; Lei Yin; Shenwei Zhang

doi:10.3389/fcvm.2026.1908839

August 18, 2026Frontiers in Cardiovascular MedicineOpen Access

A case report: Transcatheter aortic valve replacement via femoral artery for aortic regurgitation post-CARVAR

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Key result

Ultra-high release TAVR successfully treats recurrent post-CARVAR aortic regurgitation, improving LVEF ~7 points.

n=1

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Why the study?

Current clinical experience with TAVR in patients following CARVAR is limited, and procedural challenges differ fundamentally due to surgically remodeled aortic root anatomy.

Does transcatheter aortic valve replacement (TAVR) improve cardiac function in a high-risk patient with recurrent severe aortic regurgitation and severely reduced LVEF following CARVAR?

Key Points

To evaluate the feasibility and clinical efficacy of transcatheter aortic valve replacement via the femoral artery as a transitional therapy in a high-risk patient experiencing recurrent severe aortic regurgitation following comprehensive aortic root and valve repair.
Treated a 26-year-old male presenting 8 years after comprehensive aortic root and valve repair (CARVAR) with severe aortic regurgitation, severe left ventricular enlargement, and a left ventricular ejection fraction of 17.7%.
Performed transfemoral transcatheter aortic valve replacement utilizing a retrievable self-expanding Taurus Elite AV29 valve delivered via a snare-assisted technique.
Employed an ultra-high release strategy deploying the valve 8–10 mm above the native annulus, anchoring primarily against the 22.3 mm sinotubular junction ring and thickened leaflets.
Immediate post-deployment echocardiography and angiography revealed normal prosthetic valve function with no paravalvular leakage and no coronary ostial obstruction.
Procedure avoided injury to the conduction system, resulting in no requirement for permanent pacemaker implantation.
At 3-month follow-up echocardiography, left ventricular ejection fraction improved from 17.7% to 24.9% with documented reduction in left ventricular chamber dimensions.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does transcatheter aortic valve replacement (TAVR) improve cardiac function in a high-risk patient with recurrent severe aortic regurgitation and severely reduced LVEF following CARVAR?

P

Population

A 26-year-old male with recurrent severe aortic regurgitation and a left ventricular ejection fraction of 17.7% following previous CARVAR surgery, followed for 3 months after TAVR.

I

Intervention

Transcatheter aortic valve replacement (TAVR) via femoral artery using a Peijia Taurus Elite AV29 self-expanding valve, utilizing a snare-assisted delivery and an ultra-high release technique (8-10 mm above the native annulus).

O

Outcome

Procedural success and valve function (including paravalvular leakage and LVEF improvement) at 3 months postoperatively.surrogate

Limitations

Only 3-month mid-term follow-up data are available, which are insufficient to assess long-term valve durability or late coronary-related complications in a young patient.
As a single-center, single-case experience, its generalizability is limited; large-scale multicenter prospective cohort studies are needed.
There is currently no established standard for long-term management of TAVR as a bridging therapy in this context.
Only 3-month mid-term follow-up data are available, insufficient to assess long-term valve durability or late coronary-related complications
Single-center, single-case experience with limited generalizability
No established standard for long-term management of TAVR as a bridging therapy

Implication

TAVR utilizing an ultra-high release technique is a feasible and effective bridging therapy for high-risk patients with recurrent aortic regurgitation and severely reduced ejection fraction following CARVAR surgery.

Abstract

A 26-year-old male patient experienced recurrent severe aortic regurgitation accompanied by left ventricular enlargement and a left ventricular ejection fraction of 17.7% 8 years after undergoing comprehensive aortic root and valve repair (CARVAR). Given the high risks associated with redo sternotomy and the patient's explicit refusal of both redo sternotomy and heart transplantation, a multidisciplinary consultation led to the decision to perform transcatheter aortic valve replacement (TAVR) as a transitional treatment. The transvalvular procedure was performed with snare-assisted valve delivery devices and ultra-high release technique. Postoperative echocardiography demonstrated normal valve function without perivalvular leakage, with significant improvement in cardiac function compared to baseline. This case illustrates that TAVR can serve as an effective transitional therapeutic strategy for high-risk patients with recurrent aortic regurgitation following CARVAR.

Discussion

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Cite This Study

Li et al. (2026) conducted a case report in Recurrent severe aortic regurgitation post-CARVAR (n=1). Transcatheter aortic valve replacement (TAVR) with ultra-high release technique was evaluated on Procedural success and cardiac function improvement (LVEF) at 3 months. Transcatheter aortic valve replacement via femoral artery using an ultra-high release technique successfully treated recurrent aortic regurgitation post-CARVAR, improving LVEF from 17.7% to 24.9%.

synapsesocial.com/papers/6ad0fcb515427f6a84040262 https://doi.org/10.3389/fcvm.2026.1908839

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A case report: Transcatheter aortic valve replacement via femoral artery for aortic regurgitation post-CARVAR

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

A case report: Transcatheter aortic valve replacement via femoral artery for aortic regurgitation post-CARVAR

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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