Study design and patient characteristics
The present case-series is a single-center, retrospective, observational study. The Biomedical Research Ethics Committee of West China Hospital of Sichuan University approved the present study. The study complied with the Declaration of Helsinki. This study was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University. All the patients enrolled were diagnosed to have severe pure AR by transthoracic echocardiographic (TTE). The echocardiography standard criteria were defined as pure AR. A vena contracta area (VCA) on echocardiographic images > 0.6 cm indicates severe AR11. Patients with mixed valve disease or a peak aortic jet velocity of ≥ 2.5 m/s were excluded from the study12. The inclusion criteria for patients in the study were: (i) patients’ age ≥60 with NYHA functional class of Ⅱ-Ⅳ; and (ii) patients were assessed to have severe AR with an indication for TAVR by a multidisciplinary heart team. All patients signed written informed consent for prospective data acquisition and follow-up examinations.