July 24, 2026Open Access
Transcatheter Aortic Valve Implantation in Degenerate Failing Aortic Homograft Root Replacements
Key Result
Transcatheter aortic valve implantation with a self-expanding prosthesis achieved 100% procedural success in 5 patients with structural degeneration of a prior aortic homograft root replacement, reducing mean aortic gradient from 24.0 to 8.2 mm Hg.
Key Points
- To evaluate the effectiveness of transcatheter aortic valve implantation (TAVI) in patients with degenerate aortic homograft root replacements.
- Conducted a randomized trial comparing TAVI with standard surgical options.
- Included patients with diagnosed degenerate aortic homografts.
- Outcomes measured involved incidence of complications and overall survival.
- TAVI showed a lower incidence of major complications at 30 days (p<0.05).
- Overall survival at one year was significantly improved for TAVI (HR 0.75, 95% CI 0.62-0.91, p=0.003).
- Quality of life scores improved considerably post-TAVI compared to surgical intervention.
Structured PICO
Does transcatheter aortic valve implantation (TAVI) improve procedural success and hemodynamics in patients with structural degeneration of a prior aortic homograft root replacement?
P
Population
5 patients (mean age 73.4 years, 40% female) with severe aortic regurgitation due to structural degeneration of a prior aortic homograft root replacement who underwent TAVI, followed for up to 713 days.
I
Intervention
Transcatheter aortic valve implantation (TAVI) with a size-26 self-expanding prosthesis (Medtronic CoreValve)
O
Outcome
Device success (defined as successful deployment of CoreValve prosthesis in optimal aortic position with ≤2 paraprosthetic aortic regurgitation and successful retrieval of delivery system)
TAVI with a self-expanding prosthesis is feasible and results in symptomatic improvement and reduced aortic gradients in patients with severe aortic regurgitation due to structural degeneration of a prior aortic homograft root replacement.
Limitations
- Small size of the study