September 1, 2015Open Access

Redo aortic valve surgery versus transcatheter valve-in-valve implantation for failing surgical bioprosthetic valves: consecutive patients in a single-center setting.

Q: What are the key findings of this study?

Transcatheter valve-in-valve implantation for failing surgical bioprostheses was associated with lower 1-year survival compared to redo surgery (83% vs. 96%, P<0.001).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Failing bioprosthetic surgical valves (n=102). Intervention: Transcatheter aortic valve-in-valve implantation (TAV-in-SAV) vs. Surgical aortic valve redo-operation (SAV-in-SAV). Primary outcome: 1-year survival (p=<0.001).

Q: What does this research mean for the field?

Transcatheter valve-in-valve implantation for failing surgical bioprosthetic aortic valves is associated with lower 1-year survival compared to redo surgery (83% vs. 96%), despite similar 30-day mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Transcatheter valve-in-valve linked to ~13% lower 1-year survival compared to redo surgery.

P<0.001
n=102

Why the study?

An increase in patients with failing bioprosthetic surgical valves needing reoperation is expected, and a comprehensive evaluation comparing valve-in-valve TAVI to redo surgery outcomes has not been performed.

Does transcatheter valve-in-valve implantation improve postoperative outcomes compared to redo surgery in patients with failing surgical bioprosthetic valves?

Population

102 patients with failing bioprosthetic surgical aortic valves requiring reoperation

Comparison

Transcatheter valve-in-valve implantation (TAV-in-SAV) vs redo surgical aortic valve replacement (SAV-in-SAV)

Design

Retrospective single-center cohort study

Follow-up

1 year

Authors

MEMagdalena Erlebach MWMichael Wottke MDMarcus-André Deutsch

Discussion

Member takes

Overview

Lower survival after valve-in-valve warrants caution in selection; leaves open whether outcomes differ after risk matching.

Study Design

Type

Cohort (n=102)

Multicenter

Structured PICO

Does transcatheter valve-in-valve implantation improve postoperative outcomes compared to redo surgery in patients with failing surgical bioprosthetic valves?

Population

102 patients with failing bioprosthetic surgical valves who underwent either transcatheter valve-in-valve implantation or redo surgery, evaluated for postoperative outcomes.

Exposure

Transcatheter aortic valve-in-valve implantation (TAV-in-SAV) (n=50)

Comparator

Standard redo surgical aortic valve replacement (SAV-in-SAV) (n=52)

Outcome

30-day mortality and post-procedural complicationshard clinical

Main Result

Absolute Event Rate: 83% vs 96%

p-value: p=<0.001

Transcatheter valve-in-valve implantation offers a safe, less-invasive alternative to redo surgery with comparable 30-day mortality and fewer pacemaker implantations, though long-term survival may reflect the higher baseline risk of patients selected for the transcatheter approach.

Limitations

Retrospective design
Single-center setting
Significant differences in baseline comorbidities between groups

Cite This Study

Erlebach et al. (2015) conducted a cohort in Failing bioprosthetic surgical valves (n=102). Transcatheter aortic valve-in-valve implantation (TAV-in-SAV) vs. Surgical aortic valve redo-operation (SAV-in-SAV) was evaluated on 1-year survival (p=<0.001). Transcatheter valve-in-valve implantation for failing surgical bioprostheses was associated with lower 1-year survival compared to redo surgery (83% vs. 96%, P<0.001).

synapsesocial.com/papers/6ab0d910e30461dadc64b940 https://doi.org/10.3978/j.issn.2072-1439.2015.09.24

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September 1, 2015Open Access

Redo aortic valve surgery versus transcatheter valve-in-valve implantation for failing surgical bioprosthetic valves: consecutive patients in a single-center setting.

View Full Paper

Ask AI

Bookmark

Key result

Transcatheter valve-in-valve linked to ~13% lower 1-year survival compared to redo surgery.

P<0.001
n=102

Why the study?

Does transcatheter valve-in-valve implantation improve postoperative outcomes compared to redo surgery in patients with failing surgical bioprosthetic valves?

Population

102 patients with failing bioprosthetic surgical aortic valves requiring reoperation

Comparison

Transcatheter valve-in-valve implantation (TAV-in-SAV) vs redo surgical aortic valve replacement (SAV-in-SAV)

Design

Retrospective single-center cohort study

Follow-up

1 year

Authors

MEMagdalena Erlebach MWMichael Wottke MDMarcus-André Deutsch

Discussion

Member takes

Overview

Lower survival after valve-in-valve warrants caution in selection; leaves open whether outcomes differ after risk matching.

Study Design

Type

Cohort (n=102)

Multicenter

Structured PICO

Does transcatheter valve-in-valve implantation improve postoperative outcomes compared to redo surgery in patients with failing surgical bioprosthetic valves?

Population

102 patients with failing bioprosthetic surgical valves who underwent either transcatheter valve-in-valve implantation or redo surgery, evaluated for postoperative outcomes.

Exposure

Transcatheter aortic valve-in-valve implantation (TAV-in-SAV) (n=50)

Comparator

Standard redo surgical aortic valve replacement (SAV-in-SAV) (n=52)

Outcome

30-day mortality and post-procedural complicationshard clinical

Main Result

Absolute Event Rate: 83% vs 96%

p-value: p=<0.001

Limitations

Retrospective design
Single-center setting
Significant differences in baseline comorbidities between groups

Cite This Study

synapsesocial.com/papers/6ab0d910e30461dadc64b940 https://doi.org/10.3978/j.issn.2072-1439.2015.09.24

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

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