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. 2025 Jan 17;9(5):100393.
doi: 10.1016/j.shj.2024.100393. eCollection 2025 May.

Repeat Interventions After Transcatheter Aortic Valve Replacement: Clinical Characteristics and Outcomes of Redo Transcatheter Aortic Valve Replacement and Surgical Explants

Gustavo Mendez-Hirata  1 , Christian W Schmidt  1 , Geoffrey A Answini  1 , J Michael Smith  1 , Saad Hasan  1 , Jeffrey Griffin  1 , Robert Dowling  1 , Dean J Kereiakes  1 , Puvi Seshiah  1 , Joseph Choo  1 , Zaid Alirhayim  1 , Santiago Garcia  1
Affiliations

Repeat Interventions After Transcatheter Aortic Valve Replacement: Clinical Characteristics and Outcomes of Redo Transcatheter Aortic Valve Replacement and Surgical Explants

Gustavo Mendez-Hirata et al. Struct Heart. .

Abstract

Background: Transcatheter aortic valves (TAVs) are subject to degeneration and repeat intervention. TAVs are increasingly used in clinical practice, but there is a paucity of data regarding repeat interventions.

Methods: We sought to describe and compare clinical characteristics and outcomes of TAV in TAV procedures vs. surgical explant procedures after an index transcatheter aortic valve replacement (TAVR) at The Christ Hospital Health Network (Cincinnati, OH) from January 2015 to August 2023.

Results: A total of 1314 patients underwent TAVR procedures during the study period. Of these patients, 31 (2.3%) underwent repeat interventions (25 TAV in TAV and 6 surgical explants) and were included. The median [interquartile range] time from index TAVR to a repeat intervention was 5.02 years [1.01-7.12] for TAV in TAV and 2.55 years [1.36-3.20] for surgical explants (p = 0.386). Patients undergoing TAV in TAV were more likely to have structural valve deterioration (60%), whereas patients undergoing surgical explants were more likely to present with infective endocarditis (50%). Major adverse cardiovascular event rates were similar at discharge (20 vs. 17%, p = 1.00). No mortality events were presented in TAVR explant patients. Two strokes presented in TAVR explant patients, 1 at discharge and 1 at 30 days.

Conclusions: Repeat interventions are uncommon in the first decade after TAVR. In clinical practice, the mechanism of failure of the TAVR valve is an important determinant of subsequent treatment; most patients with structural valve deterioration receive a TAV in TAV procedure, whereas surgical explants are usually reserved for infective endocarditis.

Keywords: Redo-TAVR; TAVR explantation; Transcatheter aortic valve replacement; Transcatheter heart valve; Valve-in-valve.

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Figures

Figure 1
Figure 1
Patient flowchart. Abbreviations: TAV, transcatheter aortic valve; TAVR, transcatheter aortic valve replacement; ViV, valve in valve.
Figure 2
Figure 2
Study summary and findings. Created with BioRender.com. Abbreviations: BVD, bioprosthetic valve degeneration; MACE, major adverse cardiac events; SVD, structural valve deterioration; TAV, transcatheter aortic valve; TAVR, transcatheter aortic valve replacement.
See this image and copyright information in PMC

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References

    1. Carroll J.D., Mack M.J., Vemulapalli S., et al. STS-ACC TVT registry of transcatheter aortic valve replacement. Ann Thorac Surg. 2021;111(2):701–722. doi: 10.1016/j.athoracsur.2020.09.002. - DOI - PubMed
    1. Smith C.R., Leon M.B., Mack M.J., et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–2198. doi: 10.1056/NEJMoa1103510. - DOI - PubMed
    1. Adams D.H., Popma J.J., Reardon M.J., et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370(19):1790–1798. doi: 10.1056/NEJMoa1400590. - DOI - PubMed
    1. Leon M.B., Smith C.R., Mack M.J., et al. Transcatheter or surgical aortic-valve replacement in Intermediate-risk patients. N Engl J Med. 2016;374(17):1609–1620. doi: 10.1056/NEJMoa1514616. - DOI - PubMed
    1. Reardon M.J., Van Mieghem N.M., Popma J.J., et al. Surgical or transcatheter aortic-valve replacement in Intermediate-risk patients. N Engl J Med. 2017;376(14):1321–1331. doi: 10.1056/NEJMoa1700456. - DOI - PubMed

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