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Aortic regurgitation (AR) refers to the reverse flow of blood from the aorta into the left ventricle during diastole caused by incomplete closure of the aortic valve. Pathological causes of aortic regurgitation include valvular degeneration and aortic root dilation (with or without involvement of the mitral valve), rheumatic fever, aortic root dissection, Marfan syndrome, or rheumatic diseases ^[1]. Acute aortic regurgitation may cause heart failure and cardiogenic shock. Chronic aortic regurgitation is generally asymptomatic and latent for many years, while its symptoms such as exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea and palpitations will gradually become more noticeable.

A China-DVD study has shown that AR ranks third among diseases in elderly patients over 60 years of age (22.9%), much higher than the prevalence of AS (6.39%) ^[2]. AR patients experience a long symptom-free period and are usually old when they show clinical symptoms due to cardiac decompensation, with an incidence of severe heart failure at about 50%. Only 20% of patients with severe AR and LVEF at 30% to 50% have received SAVR, while only 3% of patients with LVEF <30% have received SAVR ^[3].

Similar to AS, Chinese and foreign researchers have also begun to explore the feasibility of TAVR in AR patients with high surgical risk, such as symptomatic AR patients or asymptomatic AR patients but with left ventricular dysfunction. In clinical practice, aortic insufficiency is still treated mainly by conventional surgery through valve replacement or valve repair, to correct abnormal cardiac structures and improve the prognosis. At present, aortic valve replacement or repair is performed, while the clinical effects of percutaneous aortic valve replacement are being evaluated ^[1].

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