Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Aortic valve-in-valve (AViV) replacement for is approved for patients with degenerated surgical valves at high or prohibitive surgical risk, mostly on the basis of small series with short-term follow-up.
Objectives: The aim of this study was to analyze the outcomes of AViV therapy using contemporary balloon-expandable valves (BEVs) in a large series with mid-term outcomes.
Methods: BEV AViV patients (June 2015 to December 2023) in the Society for Thoracic Surgeons (STS)/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry were propensity matched to native transcatheter aortic valve replacement (TAVR) patients. Primary analysis included death and stroke at 5 years. Comparisons were also made on the basis of STS score, BEV subtype, and stented vs stentless index surgical valve type.
Results: In total, 14,474 AViV patients were matched to 385,556 TAVR patients (13,638 pairs). The mean age was 74 years, and the mean STS Predicted Risk of Mortality was 6.1%. Emergency cardiac surgery (0.2%) and bioprosthetic valve fracture (22%) were infrequent. Death (43.1% vs 55.2%; P < 0.001), stroke (10.5% vs 11.8%; P < 0.001), and their composite were lower for AViV compared with TAVR at 5 years with similar findings at each STS tertile. The SAPIEN 3 Ultra RESILIA device demonstrated lower discharge echo gradients for all sizes (20 mm, 19.4 mm Hg vs 23.8 mm Hg; 23 mm, 15.1 mm Hg vs 19.2 mm Hg; 26 mm, 12.1 mm Hg vs 15.1 mm Hg; and 29 mm, 8.6 mm Hg vs 12.1 mm Hg). There was no difference in death or stroke at 5 years for stentless vs stented surgical valves (42.9% vs 46.0%; P = 0.12).
Conclusions: This large, real-world analysis confirms the safety and durability of AViV compared with TAVR at all surgical risk levels at mid-term follow-up. Consideration may be given to broadening the indication for AViV.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcin.2025.06.039 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Decision-making in valve reintervention: Redo-Transcatheter aortic valve replacement vs. explant surgery.
Cardiovasc Revasc Med
August 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA; Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address:
Objective: Data remain limited on factors influencing the selection of redo-transcatheter aortic valve replacement (TAVR) versus surgical explant in patients with failing transcatheter heart valves. This study aimed to identify clinical and procedural factors guiding treatment decisions.
Methods: This single-center, retrospective study included all patients who underwent aortic valve reintervention following prior TAVR at a U.
Predicting the Surge in Valve-in-Valve Volume: A Comparative Study of Japan and the United States.
JACC Asia
August 2025
Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
Background: Understanding trends in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) utilization is essential for predicting valve-in-valve (ViV) TAVR usage, a viable option for failed bioprosthetic valves that presents a promising avenue for lifetime management of aortic stenosis.
Objectives: This study aimed to predict and compare the future annual ViV volume in the United States and Japan based on past and current TAVR/SAVR utilization under some underlying assumptions.
Methods: We developed a MATLAB-based Monte Carlo model engine to simulate the lifespan of bioprosthetic TAVR and SAVR valves.
The TAVI Dilemma: Balloon-Expandable or Self-Expanding Transcatheter Heart Valve-Interpreting Current Evidence for Personalized Valve Selection.
J Clin Med
August 2025
1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Transcatheter aortic valve implantation (TAVI) has transformed the treatment of aortic valve stenosis, offering a less invasive alternative to surgical valve replacement, particularly in elderly and high-risk populations. As TAVI expands into younger, lower-risk patients, the choice of transcatheter heart valve has become increasingly important to optimize both immediate and long-term outcomes. Currently, Self-Expandable Valves (SEVs) and Balloon-Expandable Valves (BEVs) are the two most widely used platforms, each characterized by distinct design features, implantation techniques, and hemodynamic profiles.
View Article and Find Full Text PDFLong-Term Outcomes in Valve-in-Valve TAVR: Expanding the Evidence From Registry to Practice.
JACC Cardiovasc Interv
August 2025
Medizinische Klinik I, University Hospital of Ludwig-Maximilians University, Munich, Germany. Electronic address:
Mid-Term Outcomes of Balloon-Expandable Aortic Valve-in-Valve Replacement in the United States.
JACC Cardiovasc Interv
August 2025
Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, Missouri, USA.
Background: Aortic valve-in-valve (AViV) replacement for is approved for patients with degenerated surgical valves at high or prohibitive surgical risk, mostly on the basis of small series with short-term follow-up.
Objectives: The aim of this study was to analyze the outcomes of AViV therapy using contemporary balloon-expandable valves (BEVs) in a large series with mid-term outcomes.
Methods: BEV AViV patients (June 2015 to December 2023) in the Society for Thoracic Surgeons (STS)/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry were propensity matched to native transcatheter aortic valve replacement (TAVR) patients.