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Reoperation After Transcatheter Aortic Valve Replacement: An Analysis of the Society of Thoracic Surgeons Database

Thursday, June 11, 2020

Submitted by

Emily Farkas

Source

Source Name: Journal of the American College of Cardiology: Cardiovascular Interventions

Source URL: https://interventions.onlinejacc.org/content/early/2020/06/05/j.jcin.2020.04.029

Author(s)

Oliver K. Jawitz, Brian C. Gulack, Maria V. Grau-Sepulveda, Roland A. Matsouaka, Michael J. Mack, David R. Holmes Jr., John D. Carroll, Vinod H. Thourani and J. Matthew Brennan

As TAVR is used in progressively lower-risk cohorts, management of device failure will become increasingly important. This study reports the largest series of patients receiving a surgical reoperation after transcatheter aortic valve replacement (TAVR) using the STS Adult Cardiac Surgery Database. A total of 123 patients met inclusion criteria, and cases represent predominantly early TAVR failure (months to a few years from index procedure). Reoperation was associated with an operative mortality of 17.1% and other worse-than-expected outcomes when compared with similar patients initially undergoing surgical aortic valve replacement. Continued experience with this developing technology is needed to reduce the incidence of early TAVR failure and further define optimal treatment of failed TAVR prostheses.