Objective To explore the efficacy of ransapical-transcatheter aortic valve replacement(TA-TAVR)in patients with severe aortic regurgitation(AR)with different ejection fraction.Methods The clinical data of patients with severe AR undergoing TA-TAVR from November 2017 to January 2023 were retrospective reviewed,severe AR patients with left ventricular ejection fraction(LVEF)≥50％were included in the ejection fraction preserved group and patients with severe AR with LVEF＜50％were included in the reduced ejection fraction group.Clinical data of the patients in group 2 were analyzed.Results A total of 60 patients were included,including 24 in ejection fraction preserved group and 36 in reduced ejection fraction group.All group had significantly improved aortic regurgitation volume 1 day after surgery compared with preoperative volume.The left ventricular remodeling(LVR)indexes[left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESD),left ventricular posterior wall thickness(LVPW),LVEF]improved significantly at 1 day after surgery,and remained relatively stable thereafter.The improvement in LVR in reduced ejection fraction group patients was only 3 months after surgery.Two groups of patients had a decrease in amino-terminal probrain natriuretic peptide(NT-proBNP)levels three months after surgery compared to before.Patients in ejection fraction preserved group remained stable thereafter,while patients in reduced ejection fraction group had an increase one year after surgery compared to before.The one-year heart failure rehospitalization rate in reduced ejection fraction group was higher than that in ejection fraction preserved group,and the mean scores of EQ-5D-3L and EQ-VAS were lower than those of patients in ejection fraction preserved group.Comparison of the incidence of atrial fibrillation,third degree atrioventricular block,and permanent pacemaker implantation rate,stroke incidence,leaflet thrombosis incidence,paravalvular leakage incidence,and survival rate,the usage of some drugs at 1 year in both group,there was no statistically significant difference(all P＞0.05).Conclusions TA-TAVR can effectively relieve aortic regurgitation in severe AR patients with different ejection fraction and promote left ventricular reverse remodeling.Intervention in patients with severe AR with preserved ejection fraction should be performed as early as possible.