Valvular & structural heart disease
Explant vs Redo-TAVR After Transcatheter Valve Failure: Mid-Term Outcomes From the EXPLANTORREDO-TAVR International Registry
Authors' conclusion
TAVR-explant had higher mortality at 30 days and 1 year, but similar rates on landmark analysis after 30 days.
Study context
- Population
- Patients with transcatheter heart valve failure undergoing reintervention during a separate admission from the initial transcatheter aortic valve replacement (TAVR), EXPLANTORREDO-TAVR registry, May 2009 to February 2022
- Participants
- 396 patients
- Exposure
- TAVR-explant vs redo-TAVR
- TAVR-explantn = 181
- Redo-TAVRn = 215reference
- Outcome
- Mortality
- Follow-up
- 30 days and 1 year
Methodological detailsinternational, multicentre, Median follow-up 11.3 months (IQR 1.6-27.1) after reintervention
- International
- Multicentre
- Median follow-up 11.3 months (IQR 1.6-27.1) after reintervention
Main finding
As reported in the abstract
30-day mortality
P < 0.001
1-year mortality
P = 0.001
Observational data: associations, not effects.
Further findings
Time from index TAVR to reintervention
P < 0.001
Indication: prosthesis-patient mismatch
P < 0.001
Indication: structural valve degeneration
P = 0.023
Indication: ≥moderate paravalvular leak
P = 0.44
Balloon-expandable THV failures
P = 0.92
Mortality after 30 days (landmark analysis)
- Mortality similar between groups after 30 days
- P = 0.91
Stroke
- Similar stroke rates between groups
Incidence of reintervention after transcatheter heart valve (THV) failure
- Incidence of reintervention after THV failure, increasing volume over study period
- 0.59%
Original publication
Explant vs Redo-TAVR After Transcatheter Valve Failure: Mid-Term Outcomes From the EXPLANTORREDO-TAVR International Registry. JACC Cardiovasc Interv. Published 24 April 2023. doi:10.
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