TAVR for Pure AR — NCPI-Plus
TAVR for Pure AR — NCPI-Plus
Source: JACC: Case Reports, Aug 7, 2026.
• Challenge: Pure AR often lacks calcification → Poor valve anchoring → increased risk of migration /embolization.
• NCPI-plus: uses the noncoronary sinus as an additional support point to stabilize the TAVR valve and prevent migration.
• Useful in large LVOT, especially when dedicated AR valves are unavailable.
• First case: successful implantation; no Paravalvular Leak/AR at 12 months.
• TEE guidance is essential for positioning.
• Alternatives: dedicated AR valves (JenaValve/J-Valve) with leaflet anchoring.
• Limitation: single case → further validation needed.
Take-home: A promising alternative for noncalcified pure AR with challenging anatomy.
https://www.jacc.org/doi/10.1016/j.jaccas.2026.109539