Valvular & structural heart disease
Outcomes of repeat transcatheter aortic valve replacement with balloon-expandable valves: a registry study
Authors' conclusion
Redo-TAVR with balloon-expandable valves effectively treated dysfunction of the index TAVR procedure with low procedural complication rates, and death and stroke rates similar to those in patients with a similar clinical profile and predicted risk undergoing TAVR for native aortic valve stenosis.
Study context
- Population
- Consecutive patients in the STS/ACC Transcatheter Valve Therapy Registry undergoing transcatheter aortic valve replacement (TAVR) with balloon-expandable valves, Nov 2011–Dec 2022
- Participants
- 350,591 patients1,320 matched pairs
- Exposure
- Redo-TAVR vs native-TAVR with balloon-expandable valves
- Redo-TAVRn = 1,320
- Native-TAVRn = 349,271reference
- Outcome
- Death and stroke
- Follow-up
- 30 days and 1 year
Methodological detailspropensity-score matched, national registry
- Propensity-score matched
- National registry
Main finding
As reported in the abstract
Death at 30 days
P = 0.36
Death at 1 year
P = 0.57
Stroke at 30 days
P = 0.84
Stroke at 1 year
P = 0.80
Observational data: associations, not effects.
Further findings
Aortic valve gradient · 1 year
P < 0.0001
Moderate or severe aortic regurgitation · 1 year
P = 0.18
Death or stroke after redo-TAVR by timing (before/after 1 year of index TAVR) or index valve type
- Not significantly affected by timing of redo-TAVR or index transcatheter valve type
Safety
- Procedural complications of redo-TAVR
- four [0.3%] of 1320 · Coronary compression or obstruction · Intraprocedural death eight [0.6%] of 1320 · Conversion to open heart surgery six [0.5%] of 1319
Procedural complications of redo-TAVR
- Low and similar to native-TAVR
Original publication
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