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“As indications progressively expand to younger patients, with more extended anticipated lifespan, assessment of long-term valve durability and the development of strategies for managing transcatheter valve failure have become more critical.”
Observational studies reveal favorable outcomes of redo-TAVR in patients with aortic stenosis, highlighting the importance of anatomical assessment and procedural planning.
Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe aortic stenosis (AS), with indications expanding from high and intermediate- to low-surgical risk patients. However, the durability of transcatheter heart valves (THV) is still an ongoing concern, especially in younger, low-risk patients. Redo-TAVR (TAVR-in-TAVR) is feasible and is associated with favorable short-term outcomes in observational studies and registries. Understanding native aortic valve (AV) anatomy and the characteristics of the index THV is critical to the technical and procedural success of redo-TAVR. Cardiac computed tomography angiography (CTA) plays a central role in pre-procedure planning and aids in appropriate valve selection and procedural planning in addition to identifying patients at high risk for coronary occlusion during redo-TAVR. While evidence on redo-TAVR is limited to retrospective observational studies, prospective registries will shed light on the long-term clinical and hemodynamic outcomes.
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Guddeti et al. (2025) studied this question.
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