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

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.