Outcomes of Surgery After Transcatheter Aortic Valve Replacement

Surgery after TAVR, although uncommon in this database review, was associated with higher-than-expected mortality.

Transcatheter aortic valve replacement (TAVR) is now the most common therapy for severe aortic stenosis in the U.S., but when TAVR prostheses fail, the outcomes of surgery are unknown. These investigators retrospectively queried the Society of Thoracic Surgeons database for patients with a history of prior or explanted TAVR device who underwent surgery between 2011 and 2015.

Of the 123 identified patients (median age, 77; 38% women), 72 (59%) were considered to have a high preoperative risk, of whom 76% underwent urgent, emergent, or salvage surgery. The median time between TAVR and surgery, identifiable in about half of the patients, was 2.5 months. The indications for surgery included paravalvular leak (15%), structural failure (11%), sizi…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)