Key result
ViV-TAVI demonstrated lower 1-year mortality compared to redo-SAVR for failed surgical bioprostheses (RR 0.74; 95% CI 0.57-0.96; P=0.02).
Why the study?
Whether ViV-TAVI or redo-SAVR is the preferred technique for a failed surgical bioprosthesis remains debated, as existing data are limited to retrospective studies with small cohorts or short follow-up.
Does ViV-TAVI improve mortality and reduce complications compared to redo-SAVR in patients with a failed surgical bioprosthesis?
Population
Over 20 000 patients with a failed surgical bioprosthesis across 27 studies
Comparison
ViV-TAVI vs redo-SAVR
Design
Meta-analysis of 27 studies
Follow-up
Short-term and 1-year
Authors
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ViV-TAVI may be preferred over redo-SAVR for failed bioprostheses; confirms mortality benefit in Level 1 meta-analysis.
Meta-Analysis (n=20,000)
Does ViV-TAVI improve mortality and reduce complications compared to redo-SAVR in patients with a failed surgical bioprosthesis?
Relative Risk: 0.74 (95% CI 0.57–0.96)
p-value: p=0.02
ViV-TAVI for failed bioprosthesis is associated with lower 1-year mortality and fewer complications compared to redo-SAVR, though redo-SAVR provides a better hemodynamic profile.
Comentale et al. (2025) conducted a meta-analysis in Failed surgical bioprosthesis (n=20,000). Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) vs. Redo surgical aortic valve replacement (redo-SAVR) was evaluated on Short-term and long-term all-causes and cardiovascular mortality (RR 0.74, 95% CI 0.57-0.96, p=0.02). ViV-TAVI demonstrated lower 1-year mortality compared to redo-SAVR for failed surgical bioprostheses (RR 0.74; 95% CI 0.57-0.96; P=0.02).
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