Redo transcatheter aortic valve replacement effective and safe

Cedars-Sinai investigators have now shown that redo transcatheter aortic valve replacement or TAVR procedures are both safe and effective when compared with situations in which patients with similar risk profiles undergo the same procedure for the first time.

The novel findings, published in The Lancet, are significant because recent randomized clinical trials have shown that TAVR is a meaningful treatment option for both younger and lower-risk surgical patients.

At both the 30-day post-procedure mark and at one year, the team found no difference between redo TAVR or first-time TAVR in terms of death or stroke rates.

Transcatheter aortic valve replacement is a procedure that replaces a diseased aortic valve with a man-made valve. The procedure is now the standard treatment for patients with symptomatic severe aortic valve stenosis—a narrowing of the opening of the aortic valve that can cause a heart attack, heart failure, or stroke.

To generate their findings, the team utilized the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry—a national database of all consecutive patients undergoing commercial TAVR in the United States.

Among the 350,591 patients who underwent TAVR between November 2011 and December 2022, 1,320 individuals required redo procedures. The patients who underwent a repeat procedure had a mean age of 78 years old. About 58% were male and 42% female.

Reference: Outcomes of repeat transcatheter aortic valve replacement with balloon-expandable valves: a registry study, The Lancet, DOI 10.1016/PIIS0140-6736(23)01636-7