Valvular & structural heart diseaseCohort study
Mid-Term Outcomes of Balloon-Expandable Aortic Valve-in-Valve Replacement in the United States
- Retrospective cohort study
- propensity-score matched
- Society for Thoracic Surgeons (STS)/ACC TVT Registry
Authors' conclusion
This large, real-world analysis confirms the safety and durability of AViV compared with TAVR at all surgical risk levels at mid-term follow-up.
Study context
- Population
- Patients with degenerated surgical aortic valves undergoing BEV aortic valve-in-valve (AViV), STS/ACC TVT Registry, June 2015 to December 202313,638 matched pairs
- Participants
- 14,474 vs 385,556
- Exposure
- Balloon-expandable AViV vs native transcatheter aortic valve replacement (TAVR)
- AViVn = 14,474
- TAVRn = 385,556reference
- Outcome
- Death and stroke
- Follow-up
- 5 years
Main finding
As reported in the abstract
Death
P < 0.001
Stroke
P < 0.001
Observational data: associations, not effects.
Further findings
Death or stroke, stentless vs stented surgical valves · 5 years · no difference
P = 0.12
Discharge echo gradients, SAPIEN 3 Ultra RESILIA vs comparator, by valve size
- 20 mm
- 19.4 mm Hg vs 23.8 mm Hg
- 23 mm
- 15.1 mm Hg vs 19.2 mm Hg
- 26 mm
- 12.1 mm Hg vs 15.1 mm Hg
- 29 mm
- 8.6 mm Hg vs 12.1 mm Hg
- lower gradients for all sizes with SAPIEN 3 Ultra RESILIA
Safety
Emergency cardiac surgery and bioprosthetic valve fracture (AViV patients)
- Emergency cardiac surgery
- 0.2%
- Bioprosthetic valve fracture
- 22%
- described as infrequent
Original publication
Mid-Term Outcomes of Balloon-Expandable Aortic Valve-in-Valve Replacement in the United States. JACC Cardiovasc Interv. Published 25 August 2025. doi:10.1016/j.jcin.2025.06.039
Summarised from the published abstract; every number is checked against it