Key result
Valve-in-valve TAVR showed no significant difference in mid-term mortality compared to redo SAVR (RR 1.15; 95% CI 0.99-1.32; p=0.06), but had significantly lower 30-day mortality.
Why the study?
Redo SAVR and ViV TAVR are both treatment strategies for severe symptomatic bioprosthetic aortic valve dysfunction, warranting a comparison of early and mid-term outcomes.
Does ViV TAVR reduce mortality compared to redo SAVR in patients with severe symptomatic bioprosthetic aortic valve dysfunction?
Comparison
ViV TAVR vs redo SAVR
Design
Systematic review and meta-analysis of observational studies
Follow-up
Mean 26 months
Authors
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Supports short-term preference for ViV TAVR in high-risk patients; leaves open long-term durability and RCT confirmation.
Meta-Analysis (n=2,891)
Does ViV TAVR reduce mortality compared to redo SAVR in patients with severe symptomatic bioprosthetic aortic valve dysfunction?
Relative Risk: 1.15 (95% CI 0.99–1.32)
p-value: p=.06
ViV TAVR demonstrates lower 30-day mortality and similar mid-term mortality compared to redo SAVR, suggesting it should be preferred in patients at intermediate-high surgical risk.
Thandra et al. (2021) conducted a meta-analysis in bioprosthetic aortic valve disease (n=2,891). Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) vs. Redo surgical aortic valve replacement (redo SAVR) was evaluated on mid-term (1-5 years) all-cause mortality (RR 1.15, 95% CI 0.99-1.32, p=.06). Valve-in-valve TAVR showed no significant difference in mid-term mortality compared to redo SAVR (RR 1.15; 95% CI 0.99-1.32; p=0.06), but had significantly lower 30-day mortality.
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