This operational specification provides a systematic operational framework for the use of dedicated transvascular devices in transcatheter aortic valve replacement (TAVR) for patients with pure aortic regurgitation (AR). Unlike conventional systems designed for aortic stenosis, AR-specific devices incorporate specialized positioning and anchoring mechanisms that engage the native valve apparatus, effectively addressing the challenge created by the lack of annular calcification. The operational specification outlines indications and patient selection criteria, preprocedural assessment requirements, device design principles and characteristics, step-by-step procedural techniques, and strategies for preventing and managing complications associated with transvascular TAVR using these dedicated systems. The overarching aim is to improve procedural safety and reproducibility, promote broader clinical adoption of AR-specific transvascular TAVR devices, and support the optimization of long-term patient outcomes.
