Reversing Regurgitant Physiology: Pressure-Volume Insights After Dedicated TAVR for Pure Aortic Regurgitation.

Authors

Giulio M Mondellini, Lucas Uchoa de Assis, Rutger-Jan Nuis, Nicolas M Van Mieghem

Published in

JACC. Case reports. Pages 110321. Sep 15, 2026. Epub Sep 15, 2026.

Abstract

Dedicated transcatheter aortic valve replacement (TAVR) devices for the treatment of pure aortic regurgitation (AR) have emerged as an alternative to surgery for patients at high or prohibitive operative risk. However, the immediate hemodynamic effects of TAVR in this setting remain poorly characterized.
An 81-year-old man with symptomatic severe native AR underwent transfemoral TAVR using a dedicated valve system. Invasive pressure-volume analyses were performed immediately before and after valve implantation.
TAVR resulted in rapid left ventricular (LV) unloading, with reductions in end-diastolic volume and filling pressure, restored isovolumetric relaxation phase, while effective arterial elastance increased (1.25-1.52 mm Hg/mL) after elimination of regurgitant flow. End-systolic elastance increased (1.59-1.95 mm Hg/mL), with preserved ventriculo-arterial coupling. These acute physiological changes were accompanied by early symptomatic improvement and reduced diuretic requirements.
Dedicated TAVR for pure native AR results in immediate favorable changes in LV mechanics, including volume unloading and improved LV contractility.

PMID:
42742509
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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