Aortic Valve Replacement in Bioprosthetic Failure: Insights From The Society of Thoracic Surgeons National Database

Kalra, Ankur; Raza, Sajjad; Hussain, Mehwish; Shorbaji, Khaled; DeLozier, Sarah; Deo, Salil V.; Khera, Sahil; Kleiman, Neal S.; Reardon, Michael J.; Kolte, Dhaval; Gupta, Tanush; Mustafa, Rami R.; Bhatt, Deepak L.; Sabik, Joseph F.

doi:10.1016/j.athoracsur.2019.08.023

Cited by 18 publications

(7 citation statements)

References 12 publications

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“…Valve-in-valve TAVR. ViV TAVR is now commonly performed in patients with failed surgical bioprosthesis, accounting for ~7% of procedures in the transcatheter valve therapeutics registry in 2019 [ 67 ]. A large amount of observational data supports the safety and efficacy of ViV TAVR [ 68 , 69 , 70 ].…”

Section: Where Are We Going?mentioning

confidence: 99%

Evolving Indications of Transcatheter Aortic Valve Replacement—Where Are We Now, and Where Are We Going

Mesnier

Panagides

Nuche

et al. 2022

JCM

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Indications for transcatheter aortic valve replacement (TAVR) have steadily increased over the last decade since the first trials including inoperable or very high risk patients. Thus, TAVR is now the most common treatment of aortic valve stenosis in elderly patients (vs. surgical aortic valve replacement -SAVR-). In this review, we summarize the current indications of TAVR and explore future directions in which TAVR indications can expand.

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Section: Where Are We Going?mentioning

confidence: 99%

Evolving Indications of Transcatheter Aortic Valve Replacement—Where Are We Now, and Where Are We Going

Mesnier

Panagides

Nuche

et al. 2022

JCM

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“…With the increase utilization of bioprostheses, increasing cases of redo interventions are expected. Even without the utilization of transcatheter technique, the number of redo AVRs for structural valve deterioration (SVD) has been increasing [2]. In addition, patients' age has increased with low mortality rates [3].…”

Section: Introductionmentioning

confidence: 99%

Early and mid-term outcomes after aortic valve intervention in patients with previous stentless or stented bioprostheses

Fukunaga

Al-Sarraf

Jawad

et al. 2023

J Cardiothorac Surg

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Background Limited data are available concerning comparative outcomes of redo aortic valve interventions, including surgery after aortic valve replacement (AVR) with either stented or stentless bioprostheses. We investigated the comparative outcomes of redo aortic valve interventions, including surgery after AVR with either stented or stentless bioprostheses. Methods The cohort consisted of 112 patients who underwent aortic valve intervention for infective endocarditis or structural valve deterioration between 2001 and 2020. One hundred patients received a stented valve (stented group) and 12 patients received a stentless valve (stentless group) during the initial surgery. Early and late outcomes were evaluated. Results The mean [IQR] ages during the current interventions were 66 [54, 77] years in the stented group and 74 [67, 79] years in the stentless group (P = 0.13). In the stented group, aortic valve interventions included redo AVRs with stented valves (n = 54), mechanical valves (n = 26), stentless valves (n = 16), and transcatheter aortic valve implantations (n = 4). In the stentless group, redo AVRs were performed with stented valves (n = 4), mechanical valves (n = 2), stentless valves (n = 1), and transcatheter valve implantations (n = 5). Hospital mortality was observed in 2 (2%) patients in the stented group and 1 (8%) patients in the stentless group (P = 0.29). The 5-year survival was 80.8% [66.8, 88.5] in the stented group and 91.7% [53.9, 98.8] in stentless group. Statistically significant differences in thromboembolisms were observed between the groups. Conclusions No significant differences in early and mid-term outcomes (except thromboembolism) after aortic valve interventions were detected between patients with stented and stentless AVRs.

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“…Aortic valve replacements in octogenarians either as an isolated or a combined procedure are associated with a high mortality, 1,2 which increases significantly in the presence of previous cardiac surgery 3 . With the emergence of transcatheter aortic valve implantation (TAVI) there has been a decline in the number of reoperative surgical aortic valve replacements (SAVRs) 4 . The option of valve‐in‐valve transcatheter aortic valve replacement (ViV‐TAVR) has also influenced the choice of valve at the initial operation 5 .…”

mentioning

confidence: 99%

“…3 With the emergence of transcatheter aortic valve implantation (TAVI) there has been a decline in the number of reoperative surgical aortic valve replacements (SAVRs). 4 The option of valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) has also influenced the choice of valve at the initial operation. 5 With an increasing number of bio-prosthetic valves being implanted the decision-making between reoperative SAVR and ViV-TAVR will be inevitable in future.…”

mentioning

confidence: 99%

“…16 The emergence of ViV-TAVR as a therapeutic option for a failed bio-prosthetic valve has changed the narrative of treatment strategy, with an increased preference for TAVR, especially in the elderly and the high-risk population. 4 It thus becomes more pertinent to compare the outcome between redo-SAVR and ViV-TAVR. Several studies and meta-analyses have compared the outcome between redo-SAVR and ViV-TAVR.…”

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confidence: 99%

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Octogenarians needing reoperative aortic valve surgery—Does one size fit all?

Narayan

Dimagli

Angelini

2022

Journal of Cardiac Surgery

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Early and midterm outcomes, rather than long-term outcomes, are perhaps more relevant in octogenarians undergoing transcatheter aortic valve replacement (TAVR) or redo-surgical aortic valve replacement. Considering that early and midterm outcomes are similar with both the interventions, TAVR appears to be an attractive option in these patients. However, decision-making should consider other factors like presence of porcelain aorta, or severe primary mitral regurgitation among others that may influence the strategy to be adopted. The philosophy of shared decision making, and heart team consultation is, therefore, ever most relevant in these highrisk and vulnerable groups of patients. The recommendations rather than being

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Aortic Valve Replacement in Bioprosthetic Failure: Insights From The Society of Thoracic Surgeons National Database

Cited by 18 publications

References 12 publications

Evolving Indications of Transcatheter Aortic Valve Replacement—Where Are We Now, and Where Are We Going

Evolving Indications of Transcatheter Aortic Valve Replacement—Where Are We Now, and Where Are We Going

Early and mid-term outcomes after aortic valve intervention in patients with previous stentless or stented bioprostheses

Octogenarians needing reoperative aortic valve surgery—Does one size fit all?

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