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The following is a summary of “Long-term outcome of bail-out ViV-TAVI at index procedure,” published in the April 2025 issue of Clinical Research in Cardiology by Horn et al. 

Researchers conducted a retrospective study to compare in-hospital and long-term outcomes following bail-out valve-in-valve TAVI (bViV-TAVI) for failed procedures versus successful transcatheter aortic valve implantation (TAVI).  

They documented all bViV-TAVI procedures performed at the center between February 2011 and March 2022. The primary endpoint was long-term all-cause mortality, while the secondary endpoints included in-hospital mortality, stroke, acute kidney failure, the requirement for a new permanent pacemaker, and procedure duration.  

The results showed that 4,555 individuals who underwent TAVI were reviewed, and 231 matched individuals (77:154) were included in the analysis. The bViV-TAVI was observed in 1.9% of cases. In 76.7% of these, transcatheter valve embolization and migration prompted second valve implantation during the same procedure, while significant paravalvular leak (PVL) accounted for 23.4%. The duration of intervention was significantly longer in the bViV-TAVI group (P < 0.001). Rates of new permanent pacemaker implantation were higher (P= 0.013), and the postprocedural mean pressure was also elevated (P= 0.03). Other secondary outcomes showed a non-significant trend toward higher event rates in the bViV-TAVI group. After a mean follow-up of 4.9 ± 3.0 years, mortality was significantly higher in the bViV-TAVI group (54.5% vs 39.0%, P= 0.025).  

Investigators concluded that implanting a second valve during the same procedure as a bail-out for failed transcatheter aortic valve procedures was a feasible alternative, although it was associated with increased long-term mortality. 

Source: link.springer.com/article/10.1007/s00392-025-02640-5