Key result
Compared with redo SAVR, ViV-TAVR was associated with similar all-cause mortality up to 2 years, but higher late mortality after 2 years (HR 2.97; 95% CI 1.18-7.47).
Why the study?
The use of ViV-TAVR has expanded rapidly as an alternative to redo SAVR for failed bioprosthetic valves despite limited long-term data.
Does ViV-TAVR improve all-cause mortality compared to redo SAVR in patients with failed bioprosthetic aortic valves?
Population
1771 patients with failed bioprosthetic SAVR in California, New York, and New Jersey
Comparison
ViV-TAVR vs redo SAVR
Design
Retrospective population-based cohort analysis with propensity matching
Follow-up
Median (IQR) 2.3 (1.1-4.0) years
Authors
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ViV-TAVR was associated with fewer periprocedural complications but higher late mortality versus redo SAVR; leaves open durability questions for randomized trials.
Cohort (n=1,771)
Yes
Does ViV-TAVR improve all-cause mortality compared to redo SAVR in patients with failed bioprosthetic aortic valves?
Hazard Ratio: 2.97 (95% CI 1.18–7.47)
Absolute Event Rate: 23.4% vs 13.3%
While ViV-TAVR offers lower periprocedural complications compared to redo SAVR, it is associated with significantly higher late mortality and heart failure hospitalization after 2 years.
Tran et al. (2024) conducted a cohort in Failed bioprosthetic surgical aortic valve replacement (n=1,771). Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) vs. Redo surgical aortic valve replacement (redo SAVR) was evaluated on All-cause mortality (HR 2.97, 95% CI 1.18-7.47). Compared with redo SAVR, ViV-TAVR was associated with similar all-cause mortality up to 2 years, but higher late mortality after 2 years (HR 2.97; 95% CI 1.18-7.47).
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