With the treatment of aortic valve disease in younger patients, a significant number of them will need redo TAVR at some point in their life. However, to date there are few data on redo TAVR.
The aims of this study was to look at real life experience on redo TAVR with balloon-expandable SAPIEN valves and also to compare the efficacy and safety of redo TAVR against conventional TAVR. It analyzed 1216 redo-TAVR patients from the TVT registry.
Propensity score matching was carried out to compare redo TAVR against conventional TAVR. Primary end point was death and stroke at 30 days and one year. Secondary end points were procedure related, inhospital and echocardiographic events.
Mean age was 78, with STS 8.3 vs 5.2 (conventional TAVR), and 94.4% used the transfemoral approach. When looking at complications, we saw 0.4% conversion to surgery, 0.08% annulus rupture and 0.3% coronary obstruction.
Primary end point showed no significant differences in inhospital events rate (4.7% vs 3.9%; P=0.11) or at 30 days (6.1% vs 5.9%). At one year followup, the adjusted cohort showed no significant differences in mortality (HR 0.99, CI 95% 0.80-1.24;P= 0.961) or stroke (HR 0.99, CI 95% 0.62-1,60; P=0.982).
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There were higher gradients in the redo-TAVR group and symptom improvement was comparable according to NYHA and KCCQ score.
Author conclusions: there were no significant differences in mortality/stroke at 30 days or one year. With few procedure-related complications such as annulus rupture or conversion to open surgery.
Dr. Omar Tupayachi.
Member of the Editorial Board of SOLACI.org.
Reference: Presented by Raj Makkar at Late Breaking Trials Sessions, EuroPCR 2023, May 16, 2023, Paris, France.
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