{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:40:51Z","timestamp":1759732851294,"version":"build-2065373602"},"reference-count":12,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,9,16]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>We report the case of a female patient in her 60s with advanced ovarian cancer and Trousseau\u2019s syndrome, who presented with a stroke. An unusual biphasic femoral flow led to transthoracic echocardiography that revealed a severe aortic regurgitation (AR) secondary to a prolapsed right coronary aortic valve leaflet. An initial echocardiography missed the diagnosis due to tachycardia. Transcatheter aortic valve replacement (TAVR) resulted in symptom improvement. She was readmitted 2 years later with prosthetic valve thrombosis, ultimately succumbing to oncological complications. This case highlights challenges in diagnosing AR and the potential role of TAVR in patients with native pure AR (NPAR). While TAVR for NPAR poses technical challenges, newer generation transcatheter heart valves (THVs) offer promising outcomes. The Acurate NEO 2 valve was successfully used in this case. TAVR with off-label THVs can be considered for selected NPAR patients, and we can expect increased utilisation of on-label devices when availability issues are solved.<\/jats:p>","DOI":"10.1136\/bcr-2025-265514","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:25:18Z","timestamp":1759731918000},"page":"e265514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transcatheter aortic valve replacement for pure native aortic regurgitation"],"prefix":"10.1136","volume":"18","clinical-trial-number":[{"clinical-trial-number":"nct06608823","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Christina","family":"Gkotsoulia","sequence":"first","affiliation":[{"name":"Cardiology, HUG, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Mauler-Wittwer","sequence":"additional","affiliation":[{"name":"Cardiology, HUG, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dionysios","family":"Adamopoulos","sequence":"additional","affiliation":[{"name":"Cardiology, HUG, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Giannakopoulos","sequence":"additional","affiliation":[{"name":"Cardiology, HUG, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajo","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Cardiology, HUG, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Noble","sequence":"additional","affiliation":[{"name":"Cardiology, HUG, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,5]]},"reference":[{"key":"2025100523250888000_18.10.e265514.1","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2023-002319","article-title":"Impact of heart rate, aortic compliance and stroke volume on the aortic regurgitation fraction studied in an ex vivo pig model","volume":"10","author":"Reil","year":"2023","journal-title":"Open Heart"},{"key":"2025100523250888000_18.10.e265514.2","first-page":"E8","article-title":"Peripheral angiographic view of severe aortic regurgitation","volume":"24","author":"Naser","year":"2020","journal-title":"Anatol J Cardiol"},{"key":"2025100523250888000_18.10.e265514.3","unstructured":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease. 2023. Available: https:\/\/www.escardio.org\/Guidelines\/Clinical-Practice-Guidelines\/Valvular-Heart-Disease-Guidelines, https:\/\/www.escardio.org\/Guidelines\/Clinical-Practice-Guidelines\/Valvular-Heart-Disease-Guidelines"},{"key":"2025100523250888000_18.10.e265514.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.018"},{"key":"2025100523250888000_18.10.e265514.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaccas.2024.102670","article-title":"Long-Term Outcomes and Durability of a Novel Dedicated Transcatheter Heart Valve to Treat Native Aortic Regurgitation","volume":"29","author":"Bashir","year":"2024","journal-title":"JACC Case Rep"},{"key":"2025100523250888000_18.10.e265514.6","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1016\/j.jcin.2023.07.038","article-title":"Transcatheter Aortic Valve Replacement for Isolated Aortic Regurgitation Using a New Self-Expanding TAVR System","volume":"16","author":"Adam","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100523250888000_18.10.e265514.7","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1007\/s00392-019-01422-0","article-title":"Transcatheter aortic valve replacement for pure aortic valve regurgitation: \u201con-label\u201d versus \u201coff-label\u201d use of TAVR devices","volume":"108","author":"Wernly","year":"2019","journal-title":"Clin Res Cardiol"},{"key":"2025100523250888000_18.10.e265514.8","unstructured":"American College of Cardiology . TAVR for pure native aortic valve regurgitation. 2024. Available: https:\/\/www.acc.org\/Latest-in-Cardiology\/Journal-Scans\/2023\/08\/30\/16\/47\/http%3a%2f%2fwww.acc.org%2fLatest-in-Cardiology%2fJournal-Scans%2f2023%2f08%2f30%2f16%2f47%2ftranscatheter-aortic-valve-pantheon"},{"key":"2025100523250888000_18.10.e265514.9","first-page":"372","article-title":"Valve Sizing for Pure Aortic Regurgitation During Transcatheter Aortic Valve Replacement","volume":"8","author":"Zhu","year":"2015","journal-title":"JACC: Cardiovascular Interventions"},{"key":"2025100523250888000_18.10.e265514.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.carrev.2023.06.028","article-title":"First results from the ACURATE Prime XL human feasibility study","volume":"57","author":"Gooley","year":"2023","journal-title":"Cardiovasc Revasc Med"},{"key":"2025100523250888000_18.10.e265514.11","first-page":"316","article-title":"TAVR as an Alternative to SAVR for Pure Native Aortic Regurgitation","volume":"40","author":"Noble","year":"2024","journal-title":"Can J Cardiol"},{"key":"2025100523250888000_18.10.e265514.12","unstructured":"American College of Cardiology . TAVR with jenavalve for symptomatic aorticregurgitation in high surgical risk patients. 2025 Available: https:\/\/www.acc.org\/Latest-in-Cardiology\/Clinical-Trials\/2025\/03\/27\/17\/51\/align-ar"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:25:22Z","timestamp":1759731922000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":12,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,5]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bcr-2025-265514"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265514","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}