Redo aortic valve replacement vs valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis

• DOI: 10.4081/monaldi.2023.2546
• Publication Date: 2023-04-19T12:48:11Z
• Authors: Francesca Gatta; Yama Haqzad; George Gradinariu; Pietro Giorgio Ma...; Zubair Khalid; Rona L. Suelo-Cal...; Nader Moawad; Aladdin Bashir; Luke J. Rogers; Clinton Lloyd; Bao Nguyen; Karen Booth; Lu Wang; Nawwar Al-Attar; Neil McDowall; Stuart Watkins; Rana Sayeed; Saleh Baghdadi; Andrea D'Alessio; Maria Monteagudo-...; Jasmina Djordjevic; Matej Goricar; Solveig Hoppe; Charlotte Bocking; Azar Hussain; Betsy Evans; Salman Arif; Christopher Malkin; Mark Field; Kully Sandhu; Amer Harky; Ahmed Torky; Mauin Uddin; Muhammad Abdulhakeem; Ayman Kenawy; John Massey; Neil Cartwright; Nathan Tyson; Niki Nicou; Kamran Baig; Mark Jones; Firas Aljanadi; Colum G. Owens; Tunde Oyebanji; Joseph Doyle; Mark S. Spence; Paul F. Brennan; Ganesh Manoharan; Taha Ramadan; Sunil Ohri; Mahmoud Loubani
• Keywords: Mechanical valve

This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicentre UK retrospective redo-AVR or TAVI referred intervention due degenerated bioprosthesis. Propensity score matching was performed confounding factors. From July 2005 April 2021, 911 underwent 411 TAVI. There were 125 pairs analysis after propensity matching. Mean age 75.2±8.5 years. In-hospital 7.2% (n=9) vs 0 TAVI, p=0.002. Surgical suffered more post-operative complications, including IABP support (p=0.02), early re-operation (p<0.001), arrhythmias respiratory neurological complications (p=0.02 p=0.03) multi-organ failure (p=0.01). The group had shorter intensive care unit hospital stay (p <0.001 both). However, moderate regurgitation at discharge higher post-procedural gradients common (p<0.001 Survival probabilities in who successfully discharged from similar over 6-year follow-up (log-rank p=0.26). In elderly bioprosthesis, provides better outcomes, as opposed surgical replacement, although there no difference mid-term survival hospital.