Transcatheter Aortic Valve Implantation for Native Aortic Regurgitation After Healed Infective Endocarditis.

Authors

Tsz Ho Chan, Samuel Rustem Panday, Rupert Simpson, Hoda Abdelgawad, Alexandros Papachristidis, Mehdi Eskandari, Vincenzo Tufaro, Philip MacCarthy, Jonathan Byrne

Published in

JACC. Case reports. Pages 109086. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

Severe native aortic regurgitation due to cusp perforation after healed infective endocarditis presents challenges for transcatheter aortic valve implantation (TAVI), particularly without annular calcification.
A 46-year-old patient with healed infective endocarditis presented with severe eccentric aortic regurgitation due to perforation of the left coronary cusp. Given prohibitive surgical risk, transfemoral TAVI using the JenaValve Trilogy system was performed. Controlled deflection and rotational repositioning enabled coaxial alignment of the valve above the native cusps prior to deployment, resulting in no paravalvular leak and excellent hemodynamic outcome.
This case highlights the technical challenges of TAVI in aortic regurgitation with cusp perforation and demonstrates how leaflet-locator anchoring, delivery system deflection, and multimodality imaging enable safe and effective valve positioning.
Cusp perforation may cause locator misengagement during TAVI; controlled deflection and repositioning are critical to achieve safe, stable deployment.

PMID:
42467040
Bibliographic data and abstract were imported from PubMed on 17 Jul 2026.

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