The application of transcatheter aortic valve replacement in patients with pure native aortic valve regurgitation

Transcatheter aortic valve replacement (TAVR) has revolutionized the interventional treatment of severe aortic stenosis. However, pure native aortic valve regurgitation (NAVR) has been considered as a contraindication for TAVR related to the absence of valvular calcification and the subsequent difficulty in anchoring the transcatheter valves. Compared with patients with aortic stenosis, TAVR with first-generation prostheses in NAVR was associated with lower device success rate including high incidence of second valve implantation and post-procedural aortic regurgitation (moderate or severe). However, since the application of the second-generation prostheses with retrievability, external sealing cuff and optimized anchoring mechanism, the outcomes have been greatly improved. In this review, we summarize the current issues and development of TAVR for NAVR patients.