Key result
TAVR explantation at a single high-volume center had relatively low morbidity and mortality, with no significant difference between isolated SAVR and concomitant procedures (P=0.47).
Why the study?
TAVR explantation is a viable strategy when repeat TAVR is not possible, but multicenter studies have shown high morbidity and mortality.
Does TAVR explantation with SAVR plus concomitant procedures affect 30-day and 5-year outcomes compared to isolated SAVR in patients with a history of TAVR?
Cohort (n=54)
No
Does TAVR explantation with SAVR plus concomitant procedures affect 30-day and 5-year outcomes compared to isolated SAVR in patients with a history of TAVR?
p-value: p=0.47
TAVR explantation carries a relatively low risk of morbidity and mortality when performed at a high-volume structural heart center, suggesting a potential benefit to centralizing care for this complex procedure.
Background: When transcatheter aortic valve replacement (TAVR) fails and repeat TAVR is not possible, TAVR explantation remains a viable strategy. However, results from multicenter studies have shown high morbidity and mortality. This study aimed to examine early and late outcomes after TAVR explantation at a high-volume structural heart center. Methods: At a single center performing >600 TAVR procedures annually, the institutional The Society of Thoracic Surgeons registry was queried to identify all patients undergoing surgical aortic valve replacement with a history of TAVR between 2011 and 2024. Institutional trends, operative details, and outcomes at 30-days and 5-years were compared between TAVR explantation with isolated surgical aortic valve replacement (SAVR; n = 14) and TAVR explantation with SAVR plus concomitant procedures (n = 40). Results: = .47) between the isolated SAVR and concomitant procedures groups. Conclusions: The risk of morbidity and mortality was relatively low in patients undergoing TAVR explantation in a single high-volume center, a finding highlighting the potential need to centralize care for this complex procedure.
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Razavi et al. (2026) conducted a cohort in Failed transcatheter aortic valve replacement (TAVR) (n=54). TAVR explantation with isolated SAVR vs. TAVR explantation with SAVR plus concomitant procedures was evaluated on Morbidity and mortality at 30-days and 5-years (p=0.47). TAVR explantation at a single high-volume center had relatively low morbidity and mortality, with no significant difference between isolated SAVR and concomitant procedures (P=0.47).
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