Challenges and Future Directions in Redo Aortic Valve Reintervention after Transcatheter Aortic Valve Replacement Failure

Syed Zaid, Vinayak N. Bapat, Janarthanan Sathananthan, Uri Landes, Ole De Backer, Giuseppe Tarantini, Kendra J. Grubb, Tsuyoshi Kaneko, Omar K. Khalique, Hasan Jilaihawi, Miho Fukui, Mahesh Madhavan, Busra Cangut, Katherine Harrington, Vinod H. Thourani, Raj R. Makkar, Martin B. Leon, Michael J. Mack, Gilbert H.L. Tang*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Transcatheter aortic valve replacement (TAVR) is increasingly being performed in younger and lower surgical risk patients. Reintervention for failed transcatheter heart valves will likely increase in the future as younger patients are expected to outlive the initial bioprosthesis. While redo-TAVR has emerged as an attractive and less invasive alternative to surgical explantation (TAVR-explant) to treat transcatheter heart valve failure, it may not be feasible in all patients due to the risk of coronary obstruction and impaired coronary access. Conversely, TAVR-explant can be offered to most patients who are surgical candidates, but the reported outcomes have shown high mortality and morbidity. This review provides the latest evidence, current challenges, and future directions on redo-TAVR and TAVR-explant for transcatheter heart valve failure, to guide aortic valve reintervention and facilitate patients' lifetime management of aortic stenosis.

Original languageEnglish
Pages (from-to)E012966
JournalCirculation: Cardiovascular Interventions
Volume16
Issue number11
DOIs
StatePublished - 1 Nov 2023

Keywords

  • aortic valve stenosis
  • bioprosthesis
  • transcatheter aortic valve replacement

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