Ultra-low-contrast transfemoral TAVI using the MyVal transcatheter heart valve: a prospective single-center feasibility and safety study.

Background: Acute kidney injury remains clinically relevant after transcatheter aortic valve implantation (TAVI), particularly in chronic kidney disease, and iodinated contrast is a modifiable procedural contributor. Methods: We conducted a prospective single-center study of 50 patients undergoing transfemoral TAVI with an intraprocedural ultra-low-contrast strategy using the MyVal transcatheter heart valve. The primary feasibility endpoint was successful TAVI completion with total intraprocedural contrast volume ≤10 mL. Procedural outcomes, valve performance, renal function, and 30-day clinical events were assessed. Contrast-enhanced cardiac CT angiography was used for planning. Median CT contrast volume was 45 mL; median CT-to-TAVI interval was 18 days. Exploratory 6-month renal and clinical follow-up was analyzed when available. Results: Ultra-low-contrast MyVal TAVI was completed in all patients, with median contrast volume 8 mL [interquartile range, 6-10] and no procedure exceeding 10 mL. Baseline renal impairment was frequent, with median estimated glomerular filtration rate 38 mL/min/1.73 m Conclusions: In this single-center feasibility study, an intraprocedural ultra-low-contrast transfemoral TAVI strategy using the MyVal valve was feasible, with preserved early procedural success and valve performance. Renal function remained stable through 30 days, and AKI was infrequent; however, without a comparator group, these findings should be interpreted as descriptive feasibility and early safety observations rather than evidence of renal protection, AKI reduction, or superiority over standard contrast-guided TAVI. Larger comparative studies are required.