Valvular & structural heart diseaseCohort study
Transcatheter or Surgical Replacement for Failed Bioprosthetic Aortic Valves
- Retrospective cohort study
- population-based
- propensity-score matched
Authors' conclusion
Compared with redo SAVR, ViV-TAVR was associated with a lower incidence of periprocedural complications and a similar incidence of all-cause mortality through 2 years' follow-up. However, ViV-TAVR was associated with higher rates of late mortality and heart failure hospitalization.
Study context
- Population
- Patients with failed bioprosthetic surgical aortic valve replacement (SAVR) undergoing ViV-TAVR or redo SAVR in California, New York and New Jersey, 2015–2020
- Participants
- 1,771 patients · 375 matched pairs
- Exposure
- ViV-TAVR vs redo SAVR
- Outcome
- All-cause mortality
- Follow-up
- 5 years
Main finding
As reported in the abstract
ViV-TAVR vs Redo SAVRHazard ratio (95% CI)
landmark analysis, up to 2 years
1.03(0.59–1.78)
landmark analysis, after 2 years
2.97(1.18–7.47)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| HF hospitalization · after 2 years · landmark analysis | 3.81 (1.57–9.22) | |
| 0.10.31310Hazard ratio (log scale) |
Stroke, reoperation, major bleeding, infective endocarditis · 5 years
- No differences in 5-year incidence
Periprocedural mortality and stroke
- Similar between propensity-matched groups
Safety
Periprocedural major bleeding
P = 0.05
Periprocedural acute kidney failure
P < 0.001
Periprocedural new pacemaker implantation
P < 0.001
Original publication
Transcatheter or Surgical Replacement for Failed Bioprosthetic Aortic Valves. JAMA Cardiol. Published 1 July 2024. doi:10.1001/jamacardio.2024.1049
Summarised from the published abstract; every number is checked against it