OR7-7 | Repeat Intervention after Transcatheter Aortic Valve Replacement: Clinical Characteristics and Outcomes of Redo Transcatheter Aortic Valve Replacement and Surgical Explant

Transcatheteraortic valves (TAV) are subject to degeneration and repeat intervention. TAV are increasingly used in clinical practice but there is paucity of data regarding repeat interventions. We sought to describe and compare clinical characteristics and outcomes of repeat transcatheter aortic valve replacement (TAV in TAV) versus TAVR surgical explant procedures. We included all patients undergoing a repeat procedure after an index TAVR at The Christ Hospital Network (Cincinnati, OH) from 01/2015 to 08/2023. All clinical events were defined according to VARC 3 criteria. A total of 31 patients (25 TAV in TAV and 6 surgical explants) were included in the analysis. The median [IQR] time from index TAVR to TAV in TAV was 5.02 years [1.01-7.12] and 2.55 years [1.36-3.20] for surgical explants (p=0.386). Baseline characteristics and outcomes are presented in the Table. Patients undergoing TAV in TAV were more likely to have structural valve deterioration (60%) whereas patients undergoing surgical explants were more likely to present with infective endocarditis (50%). Major adverse cardiac event rates were similar at discharge and at 30 days (p=1.000 and 0.207). TAV in TAV technical and 30-day device success rates were 88% (n=22) and 84% (n=21), respectively. Kansas City Cardiomyopathy Questionnaire overall score improved at 30 days and 1 year (pTrend<0.001) after TAV in TAV. In appropriately selected patients, TAV in TAV and surgical explant are associated with acceptable safety and efficacy. The mechanism of failure of the TAVR valve is an important determinant of subsequent treatment.