What is the clinical evidence from this study?

Study design: Cohort. Population: Failing transcatheter aortic valves requiring redo-TAVR (n=292). Intervention: Redo-TAVR with Evolut R, Evolut PRO or Evolut PRO+ valve. Primary outcome: Device success.

September 17, 2021Catheterization and Cardiovascular Interventions

Redo‐transcatheter aortic valve replacement with the supra‐annular, self‐expandable Evolut platform: Insights from the Transcatheter valve Therapy Registry

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Key result

Redo-TAVR using the self-expandable Evolut platform achieved a 94.5% device success rate, with low in-hospital mortality (2.1%) and stroke (2.7%).

Why the study?

Data on the safety and efficacy of redo-TAVR (TAV-in-TAV) remain limited as indications expand to younger and lower-risk patients.

Is redo-TAVR with the Evolut platform safe and effective in patients with failing transcatheter aortic valves?

Population

292 patients undergoing redo-TAVR in the TVT Registry

Comparison

Evolut R (213 patients) vs Evolut PRO or PRO+ (79 patients)

Design

Registry-based cohort study

Follow-up

1-year

Authors

GAGuilherme F. AttizzaniOsaka University of Economics LDLuís Augusto Palma DallanUniversity Hospitals of Cleveland JFJohn K. ForrestInterventional Cardiology

Discussion

Member takes

Implication

Supports feasibility of Evolut valves in failing TAVs; hypothesis-generating and should not yet change practice.

Study Design

Type

Cohort (n=292)

Multicenter

Yes

Structured PICO

Is redo-TAVR with the Evolut platform safe and effective in patients with failing transcatheter aortic valves?

Population

292 patients undergoing redo-TAVR with the Evolut platform from the TVT Registry, evaluated for in-hospital, 30-day, and 1-year outcomes.

Exposure

Redo-TAVR using the supra-annular, self-expandable Evolut platform (Evolut R, Evolut PRO, or Evolut PRO+ valve).

Outcome

In-hospital, 30-day and 1-year safety and efficacy outcomes (including device success, mortality, stroke, coronary compression/obstruction, myocardial infarction, mean gradient, and aortic regurgitation).safety

Redo-TAVR with the Evolut platform demonstrates high device success and a favorable short-term safety profile, with low rates of in-hospital mortality and stroke, and no coronary obstruction.

Limitations

Lack of long-term follow-up data
Long-term follow-up is necessary

Cite This Study

Attizzani et al. (2021) conducted a cohort in Failing transcatheter aortic valves requiring redo-TAVR (n=292). Redo-TAVR with Evolut R, Evolut PRO or Evolut PRO+ valve was evaluated on Device success. Redo-TAVR using the self-expandable Evolut platform achieved a 94.5% device success rate, with low in-hospital mortality (2.1%) and stroke (2.7%).

synapsesocial.com/papers/6a330fe508194afa457c10d7 https://doi.org/10.1002/ccd.29941

Topics

Transcatheter aortic valve replacement TAVR in low-risk patients

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Redo‐transcatheter aortic valve replacement with the supra‐annular, self‐expandable Evolut platform: Insights from the Transcatheter valve Therapy Registry

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Redo‐transcatheter aortic valve replacement with the supra‐annular, self‐expandable Evolut platform: Insights from the Transcatheter valve Therapy Registry

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

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