Valvular & structural heart diseaseCohort study
Real-World Outcomes of Dedicated Leaflet Modification for Bioprosthetic Valve-In-Valve Transcatheter Aortic Valve Replacement (TAVR)
- Multicentre registry of consecutive postapproval cases
- VARC-3 adjudication
Authors' conclusion
In this early U.S. commercial experience, mechanical leaflet splitting demonstrated high procedural success in an anatomically high-risk ViV TAVR cohort. Serious complications occurred
Study context
- Population
- Patients undergoing valve-in-valve (ViV) TAVR at elevated CT-predicted risk of coronary obstruction, 28 US centres, February–November 2025splitting attempted in 145
- Participants
- 150 patients
- Outcome
- Procedural performance and in-hospital outcomes
- Follow-up
- In-hospital
Main finding
As reported in the abstract
Leaflet splitting success
| Group | Value | Dual-leaflet splitting |
|---|---|---|
| Leaflet splitting | 99.3% | 83 of 145 (57.2%) |
Observational data: associations, not effects.
Further findings
Coronary obstruction · in-hospital
- Coronary obstruction, 3 of 150
- 2.0%
- 95% CI: 0.7-5.7
All-cause mortality · in-hospital
- All-cause mortality, 3 of 150
- 2.0%
- 95% CI: 0.7-5.7
- 2 deaths from LV perforation, 1 after stroke
Safety
Conversion to surgery · in-hospital
- Conversion to surgery, 2 of 150
- 1.3%
- 95% CI: 0.4-4.7
Original publication
Real-World Outcomes of Dedicated Leaflet Modification for Bioprosthetic Valve-In-Valve TAVR. JACC Cardiovasc Interv. Published 25 June 2026. doi:10.1016/j.jcin.2026.06.002
Summarised from the published abstract; every number is checked against it