Transcatheter valve-in-valve or redo surgical mitral valve replacement, which is better in failed mitral bioprostheses?

The study led to the following findings:

• Patients undergoing ViV-TMVR were older with higher comorbidity rates.
• The mean length of stay (15 days vs. four days) and hospitalization costs ($76,558 vs. $46,743) were significantly more significant for redo-SMVR.
• Also, the rate of in-hospital all-cause mortality was notably lower in ViV-TMVR (2.6% vs. 7.3%).
• By contrast, both groups were comparable between 30-day all-cause mortality during the readmission episode (aOR 1.01) and all-cause readmission rates (aOR 0.82).
• The incidence of all-cause readmissions at six months (aOR 0.83) and all-cause mortality during the episode of readmission at six months (aOR 1.84) were also similar.
• The utilization of the ViV-TMVR procedure increased significantly during the study duration, from 5.2% to 36.8%.

"We found that ViV-TMVR is linked with lower odds of complications, in-hospital mortality, and resource utilization," the researchers wrote. "The all-cause readmissions and mortality of 30-day and 6-month during the readmissions were comparable between both groups."

Reference:

Zahid S, Ullah W, Hashem AM, Khan MZ, Gowda S, Vishnevsky A, Fischman DL. Transcatheter valve-in-valve implantation versus redo surgical mitral valve replacement in patients with failed mitral bioprostheses. EuroIntervention. 2022 Sep 15:EIJ-D-22-00437. doi: 10.4244/EIJ-D-22-00437. Epub ahead of print. PMID: 36106346.