Valve-in-valve transcatheter aortic valve replacement (AVR) was linked to more heart failure (HF) hospitalisations and permanent pacemaker implantation, according to the study published in the Journal of the American College of Cardiology.
However, the study found that valve-in-valve TAVR provides better short-term outcomes than redo surgical AVR among patients with a failed surgical aortic valve. Long-term major cardiovascular (CV) outcomes were similar between both the approaches.
The study analysed a cohort of 4,327 patients from a French administrative hospital-discharge database who had an aortic bioprosthesis failure treated with valve-in-valve TAVR or redo surgical AVR between 2010 and 2019. The team analysed 717 pairs with one from each group that were matched based on baseline characteristics (mean age, 75 years; 58% men in the surgery group; 56% men in the TAVR group).
At 30 days, the composite outcome of all-cause mortality, all-cause stroke, myocardial infarction (MI) or major or life-threatening bleeding occurred less often in the TAVR group compared with the surgery group, wrote Dr Pierre Deharo and colleagues from the Cardiology department at CHU Timone, Marseille, France.
However, at a median of 516 days of follow-up, the composite outcome of CV death, all-cause stroke, MI or rehospitalization did not differ between the groups, according to the researchers. HF hospitalization occurred more often in the valve-in-valve TAVR group, as did permanent pacemaker implantation, noted the authors.