Repeat Transcatheter Aortic-Valve Replacement: A Viable Treatment Option?

A large multicenter registry provides some early reassurance.

When transcatheter aortic-valve replacement (TAVR) was first approved, treatment was confined to patients at high surgical risk, and late valve failure was rare due to the competing risk for mortality. With expansion of TAVR to intermediate- and low-risk patients, many of whom have long life expectancies, management of failed TAVR valves might become commonplace. Whether repeat TAVR is safe and provides acceptable outcomes is unknown, however. To evaluate the outcomes of valve-in-valve TAVR for transcatheter valve dysfunction, investigators pooled data from 37 high-volume TAVR centers.

Among 63,876 TAVR procedures, 212 (0.33%) were redo-TAVRs; 36% were performed within 1 year after initial TAVR (median, 68 days), predominantly for regurgitat…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)