Transcatheter Aortic Valve Replacement in Pure Aortic Regurgitation: The Randomized SEASON-AR Clinical Trial.

In severe pure aortic regurgitation in China, transfemoral TAVR with VitaFlow plus GDMT reduced the 1-year composite event rate to 8.3% versus 24.8% with GDMT alone.

• Why it matters: Patients with severe pure AR at high surgical risk often have limited options beyond guideline-directed medical therapy, and prior randomized evidence versus GDMT alone was insufficiently powered.
• What they did: In a prospective multicenter randomized open-label trial, 210 patients were assigned 1:1 to transfemoral TAVR with VitaFlow plus GDMT or GDMT alone, with a 1-year composite primary endpoint.
• The result: The primary endpoint was lower with TAVR (HR 0.31, 95% CI 0.14–0.66; P=0.001), mainly due to fewer heart failure rehospitalizations (3.7% vs 21.3%; HR 0.16; P<0.001), despite higher 30-day major/life-threatening bleeding and new permanent pacemaker implantation.

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