Valvular & structural heart diseaseCohort study

Surgical Bailout During Transcatheter Aortic Valve Replacement (TAVR)

JACC Cardiovasc IntervPublished

  • Retrospective cohort study
  • national Medicare data
  • multilevel hierarchal model

Authors' conclusion

In contemporary data, the annual incidence of TAVR surgical bailout is decreasing, but the short-term mortality remains high. However, patients who survived 1 year after TAVR had similar long-term mortality to patients without surgical bailout.

Study context

Population
Medicare beneficiaries who underwent TAVR, 2016–2024
Participants
400,862 TAVRs
Exposure
TAVR with surgical bailout vs TAVR without bailout
  • TAVR bailoutn = 2,240
Outcome
30-day mortality
Follow-up
30 days

Main finding

As reported in the abstract

30-day mortality of TAVR bailout

TAVR bailout

26.3%

588 of 2,240

Observational data: associations, not effects.

Further findings

Incidence of TAVR bailout
0.56% · 2,240 of 2,240
Incidence of TAVR bailout — Annual incidence decreased 2016 to 2024
P < 0.001
30-day mortality of TAVR bailout by hospital surgical aortic valve replacement (SAVR) volume — 30-day mortality similar across volume categories
P = 0.28
  • 30-day mortality of TAVR bailout by hospital SAVR volume: Low-volume SAVR hospitals 27%
  • 30-day mortality of TAVR bailout by hospital SAVR volume: Intermediate-volume SAVR hospitals 29%
  • 30-day mortality of TAVR bailout by hospital SAVR volume: High-volume SAVR hospitals 25%

Mortality, landmark analysis

Higher mortality with TAVR bailout vs without bailout up to 1 year
P < 0.001
Similar mortality after 1 year
P = 0.53
  • median follow-up 952 days (IQR: 414-1,615 days)

Original publication

Surgical Bailout During TAVR. JACC Cardiovasc Interv. Published 14 September 2026. doi:10.1016/j.jcin.2026.06.030

Summarised from the published abstract; every number is checked against it