Transcatheter valve-in-valve aortic valve replacement (VIV TAVR) and redo surgical aortic valve replacement (SAVR) are the two commonly used practiced treatments for aortic bioprosthesis failure, but the clinical comparison of the two methods has not been well recorded. The objective of this study is to compare the outcomes of VIV TAVR and SAVR in the treatment of aortic bioprosthesis failure.

This study included information about a total of 4,327 patients treated for aortic bioprosthesis failure with isolated VIV TAVR or redo SAVR. The primary outcomes of the analysis were all-cause mortality, and cardiovascular events analyzed using propensity score matching.

Of the 4,327 patients, 717 were analyzed in each arm. At 30 days after the treatment, VIV TAVR was associated with a lower incidence of the composite of all-cause mortality, all-cause stroke, myocardial infarction, or any other type of life-threatening bleeding. However, during the median follow-up of 516 days, the combined incidence of cardiovascular death, all-cause stroke, myocardial infarction was similar in the two groups.

The research concluded that VIV TAVR produced better results in the short term than SAVR in patients with aortic bioprosthesis failure. However, there was no significant difference in major cardiovascular events between the two replacement treatments in the long term.

Ref: https://www.onlinejacc.org/content/76/5/489