Study: Redo TAVR procedures safe, effective

Editor's Note

This study by researchers at Cedars-Sinai Medical Center, Los Angeles, finds that redo transcatheter aortic valve replacement (TAVR) procedures are both safe and effective.

Of 350,591 patients in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry who underwent TAVR with balloon-expandable valves between November 2011 and December 2022, 1,320 required redo-TAVR procedures.

Among the findings:

• At 30-day and 1-year postprocedure marks, there was no significant difference between redo TAVR and first-time TAVR in death and stroke rates—4.7% vs 4.0% and 17.5% vs 19.0%, respectively.
• Rates of procedural complications of redo TAVR were low—coronary compression or obstruction (0.3%), intraprocedural death (0.6%), conversion to open heart surgery (0.5%)—and similar to first-time TAVR.
• Redo TAVR reduced aortic valve gradients at 1 year, though they were higher than first-time TAVR (15 mm Hg vs 12 mm Hg).
• Moderate or severe aortic regurgitation rates were similar between redo-TAVR and first-time TAVR groups at 1 year (1.8% vs 3.3%).
• Death or stroke rates after redo TAVR were not significantly affected by the timing (ie, before or after 1 year of the first-time TAVR) or by first-time transcatheter valve type (ie, balloon-expandable or nonballoon-expandable).

The researchers concluded that redo TAVR with balloon-expandable valves may be a reasonable treatment for failed TAVR procedures in select patients.