Key result
ViV-TAVR linked to ~55% lower 30-day mortality versus redo-SAVR.
Why the study?
The comparative efficacy and safety of ViV-TAVR and redo-SAVR in patients with degenerated bioprosthetic aortic valves remained unknown.
Does valve-in-valve TAVR reduce mortality and complications compared to redo-SAVR in patients with degenerated bioprosthetic aortic valves?
Population
8326 patients with degenerated bioprosthetic aortic valves across 11 studies
Comparison
ViV-TAVR vs redo-SAVR
Design
Meta-analysis
Follow-up
6-months to 5-years
Authors
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ViV-TAVR may be considered for lower early mortality in degenerated bioprostheses; extends observational meta-analyses but leaves long-term durability open.
Meta-Analysis (n=8,326)
Does valve-in-valve TAVR reduce mortality and complications compared to redo-SAVR in patients with degenerated bioprosthetic aortic valves?
Odds Ratio: 0.45 (95% CI 0.3–0.68)
p-value: p=0.0002
ViV-TAVR offers a short-term mortality and bleeding advantage over redo-SAVR for degenerated bioprosthetic aortic valves, though mid-to-long-term mortality is similar and ViV-TAVR carries a higher risk of prosthesis-patient mismatch.
Saleem et al. (2021) conducted a meta-analysis in Degenerated bioprosthetic aortic valve (n=8,326). Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) vs. Redo-surgical AVR (redo-SAVR) was evaluated on 30-day all-cause mortality (OR 0.45, 95% CI 0.30-0.68, p=0.0002). Valve-in-valve TAVR was associated with significantly lower odds of 30-day all-cause mortality compared to redo-SAVR (OR 0.45; 95% CI 0.30-0.68; p=0.0002).
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