[Comment] TAVI for native aortic regurgitation
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02273-1/fulltext?rss=yes

Transcatheter aortic valve implantation (TAVI) for severe, isolated, native aortic regurgitation has been challenging with use of transcatheter heart valves designed for aortic stenosis (off-label use). In several registry studies in which transcatheter heart valves were used to treat aortic regurgitation, the main concerns with this approach were the lack of leaflet calcification (which hinders valve anchoring and increases the risk of procedural failure), the frequent bicuspid valve anatomy, high rates of valve embolisation (6·4–15%), and paravalvular regurgitation (10%).

[Articles] Transcatheter aortic valve implantation with the Trilogy valve for symptomatic native aortic regurgitation (ALIGN-AR): a pivotal, multicentre, single-arm, investigational device exemption study
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02215-9/fulltext?rss=yes

In patients with symptomatic moderate-to-severe or severe aortic regurgitation considered to be of high surgical risk, TAVI with a dedicated platform met prespecified safety and effectiveness performance goals. We observed substantial reductions in aortic regurgitation, favourable valve haemodynamics and myocardial remodelling, with associated improvements in functional status and quality-of-life gains up to 2 years. These data support TAVI with a purpose-built device as a feasible and effective treatment option for selected patients with native aortic regurgitation who are at high risk for death or complications after surgery.