Valvular & structural heart disease
Three-Year Outcomes of Second Bioprosthesis After Early Surgical Aortic Bioprosthetic Failure
Main finding · Recurrent early SVDResult — go to the resultAdjusted hazard ratio 3.31 95% CI 0.43–25.5Authors' conclusion
Early failure of the second bioprosthesis after reintervention, especially following valve-in-valve TAVR, mostly occurred within the first year. Residual hemodynamic abnormalities at discharge strongly predict early SVD.
Study context
- Population
- Patients with surgical aortic valve replacement (SAVR) and early structural valve deterioration (SVD) (≤5 years) requiring reintervention, Abbott Northwestern Hospital, 2012–2022
- Participants
- 92 patients
- Exposure
- Transcatheter aortic valve replacement (TAVR)-after-SAVR vs SAVR-after-SAVR for early SVD of a surgical aortic bioprosthesis
- TAVR-after-SAVRn = 76
- SAVR-after-SAVRn = 16reference
- Outcome
- Early SVD of the second bioprosthesis (VARC-3 criteria)
- Follow-up
- Within 5 years after repeat SAVR or valve-in-valve TAVR
Methodological detailssingle-centre
- Single-centre
Main finding
Recurrent early SVD
Adjusted hazard ratio
3.31
95% CI 0.43–25.5
P = 0.23
By group
TAVR-after-SAVRvs SAVR-after-SAVR
adjusted HR 3.31 (95% CI 0.43–25.5); P = 0.23
As reported in the abstract
- Recurrent early SVD, overall
- 20 patients (21.7%)
- Occurred in the first year
- 13 (65.0%)
Observational data: associations, not effects.
Secondary outcomes
Independent predictors of recurrent early SVD · discharge or 30 days
- Mean gradient ≥20 mm Hg, aortic valve area <1.0 cm², moderate/severe aortic regurgitation were independent predictors
Mortality, stroke, HF · 3 years
- Mortality
- 18.5%
- Stroke
- 5.4%
- Congestive HF
- 26.1%
Original publication
Three-Year Outcomes of Second Bioprosthesis After Early Surgical Aortic Bioprosthetic Failure. JACC Adv. Published 5 November 2025. doi:10.
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