Impact of transcatheter heart valve type on outcomes of surgical explantation after failed transcatheter aortic valve replacement: the EXPLANT-TAVR international registry
Key result
Surgical explantation of failed self-expanding versus balloon-expandable TAVR valves resulted in similar cumulative mortality at 3 years (log-rank p=0.95).
Why the study?
Data were limited on the impact of transcatheter heart valve type on outcomes of surgical explantation following failed TAVR.
Does the type of failed transcatheter heart valve (self-expanding vs balloon-expandable) impact mortality and stroke outcomes after surgical explantation?
Population
391 patients across 42 centres undergoing TAVR explantation on a separate admission
Comparison
Failed balloon-expandable valves vs self-expanding valves
Design
Multicentre international registry study
Follow-up
3 years
Authors
Discussion
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Member takes
Implication
Similar midterm mortality after BEV versus SEV explantation; leaves open whether THV type affects lifetime TAVR management strategies.
Study Design
Type
Cohort (n=391)
Multicenter
Yes
Structured PICO
Does the type of failed transcatheter heart valve (self-expanding vs balloon-expandable) impact mortality and stroke outcomes after surgical explantation?
P
Population
391 patients (mean age 73.0 years, 33.8% female) undergoing surgical explantation for failed balloon-expandable or self-expanding TAVR valves, followed for up to 3 years.
E
Exposure
Surgical explantation for failed self-expanding valves (SEV) (n=189)
C
Comparator
Surgical explantation for failed balloon-expandable valves (BEV) (n=202)
O
Outcome
In-hospital, 30-day, and 1-year mortality and stroke rates, and cumulative mortality at 3 yearshard clinical
Main Result
p-value: p=0.95
Surgical explantation of failed self-expanding versus balloon-expandable TAVR valves is associated with different indications (more endocarditis in BEV, more paravalvular leak in SEV) but similar midterm mortality and stroke rates.
Cite This Study
Zaid et al. (2024) conducted a cohort in Failed transcatheter aortic valve replacement requiring surgical explantation (n=391). Self-expanding valves (SEV) vs. Balloon-expandable valves (BEV) was evaluated on Cumulative mortality at 3 years (p=0.95). Surgical explantation of failed self-expanding versus balloon-expandable TAVR valves resulted in similar cumulative mortality at 3 years (log-rank p=0.95).