https://www.selleckchem.com/products/Cyclopamine.html The J-Valve system is designed specifically for trans-apical transcatheter aortic valve replacement (TAVR) and has three U-shaped graspers. With the unique structure, J-Valve is suitable for both aortic stenosis and aortic regurgitation. We used the J-Valve system for patients with aortic valve diseases and observed favorable results. From January 2018 to August 2019, 23 patients underwent trans-apical transcatheter valve replacement using the J-Valve system. High-risk patients with diseased peripheral vessels (Small diameter, heavily calcified, and tortuous arteries), pure aortic regurgitation and complex prosthetic valve-in-valve (ViV) cases were enrolled. Ten patients mainly suffered from aortic stenosis, 11 patients had pure aortic regurgitation, and two patients had a ViV aortic valve position. The average preoperative STS score and EuroSCORE II were 8.9% and 8.7%, respectively. The technique success rate was 91.3% (21/23, one patient was referred for open surgery and one patient received intraoperative valve-in-valve), and one patient died because of cardiogenic shock after the procedure (mortality 4.3%, 1/22). One patient suffered stroke postoperatively and recovered well, and no cases needed to undergo permanent pacemaker implantation. During the follow-up period, one patient died because of an acute heart attack. No moderate or severe paravalvular leakage was found. TAVR surgery with the J-valve system is effective, even when it is traumatic and requires the trans-apical route. The applicability of the J-valve system in pure aortic regurgitation patients is the advantage of this system. TAVR surgery with the J-valve system is effective, even when it is traumatic and requires the trans-apical route. The applicability of the J-valve system in pure aortic regurgitation patients is the advantage of this system.We experienced a rare case of intraoperative type A aortic dissection during HeartMate II implantat