Impact of TAVR Failure Mechanism on Outcomes After Reintervention: From the EXPLANTORREDO-TAVR Registry

BACKGROUND: As transcatheter aortic valve replacement (TAVR) expands to patients with longer life expectancy, the impact of failure mechanisms on outcomes of TAVR-explant and redo-TAVR remains uncertain. We sought to evaluate outcomes of TAVR reintervention based on the failure mechanism of the index transcatheter aortic valve. METHODS: From 2009 to 2022, 553 patients from 29 centers in the EXPLANTORREDO-TAVR registry underwent TAVR-explant or redo-TAVR for transcatheter aortic valve failure. Patients with endocarditis were excluded. Patients with structural valve deterioration (SVD, N=224 [64.9%]) were compared with those with nonstructural valve dysfunction (NSVD, N=121 [35.1%]), comprising paravalvular leak (86.0%) and prosthesis-patient mismatch (14.0%). Outcomes were assessed at 30 days and 1 year. RESULTS: =0.53). CONCLUSIONS: SVD and NSVD failures had distinct valve types and reintervention timing, with SVD having a longer time to TAVR reintervention, but the failure mechanism did not impact reintervention type or clinical outcomes.

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Journal
Circulation Cardiovascular Interventions
Published
2026-04-15
DOI
https://doi.org/10.1161/circinterventions.125.016068
Primary Topic
Cardiac Valve Diseases and Treatments
Type
article
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article

Impact of TAVR Failure Mechanism on Outcomes After Reintervention: From the EXPLANTORREDO-TAVR Registry

Tsuyoshi Kaneko, Igor Belluschi, Syed Zaid, Anson Cheung et al.
Circulation Cardiovascular Interventions
Cardiac Valve Diseases and Treatments
article

Impact of TAVR Failure Mechanism on Outcomes After Reintervention: From the EXPLANTORREDO-TAVR Registry

Tsuyoshi Kaneko, Igor Belluschi, Syed Zaid, Anson Cheung, Rik Adrichem, Molly Szerlip, Tamim Nazif, Nimesh D. Desai, Emily Shih, Jörg Kempfert, Ole De Backer, Bhavanadhar Penta, Anita Asgar, Christian C. Schults, Vinayak Bapat, Mohamed Abdel‐Wahab, Neal S. Kleiman, George Petrossian, Luigi Pirelli, Shinichi Fukuhara, Axel Unbehaun, Arnar Geirsson, John K. Forrest, Gilbert H.L. Tang, Silvia Corona, Thijmen W. Hokken, Martin Andreas, Howard C. Herrmann, John Michael DiMaio, Lenard Conradi, Keti Vitanova, Markus Krane, Michael J. Reardon, Joshua D. Rovin, Chad Kliger, Sachin S. Goel, Martin B. Leon, Newell Robinson, Moritz Wyler von Ballmoos, Joshua B Goldberg, Nicolas Van Mieghem, Shekhar Saha, Philipp Kiefer, C Hagl, Basel Ramlawi, David Meier, J G Webb, T Modine, Mateo Marín-Cuartas, Michael J. Mack, Andrea Colli, Lin Wang, Walid Ben-Ali, Marco Di Eusanio, Paolo Denti, On behalf of the EXPLANTORREDO-TAVR Registry Investigators, Maurizio Taramasso, Oliver Bhadra, Ron Waksman, Hendrik Ruge
article en

Abstract

BACKGROUND: As transcatheter aortic valve replacement (TAVR) expands to patients with longer life expectancy, the impact of failure mechanisms on outcomes of TAVR-explant and redo-TAVR remains uncertain. We sought to evaluate outcomes of TAVR reintervention based on the failure mechanism of the index transcatheter aortic valve. METHODS: From 2009 to 2022, 553 patients from 29 centers in the EXPLANTORREDO-TAVR registry underwent TAVR-explant or redo-TAVR for transcatheter aortic valve failure. Patients with endocarditis were excluded. Patients with structural valve deterioration (SVD, N=224 [64.9%]) were compared with those with nonstructural valve dysfunction (NSVD, N=121 [35.1%]), comprising paravalvular leak (86.0%) and prosthesis-patient mismatch (14.0%). Outcomes were assessed at 30 days and 1 year. RESULTS: =0.53). CONCLUSIONS: SVD and NSVD failures had distinct valve types and reintervention timing, with SVD having a longer time to TAVR reintervention, but the failure mechanism did not impact reintervention type or clinical outcomes.

Circulation Cardiovascular Interventions
University of Pisa (IT), MedStar Washington Hospital Center (US), Houston Methodist (US), MedStar National Rehabilitation Hospital (US), Michael E. DeBakey VA Medical Center (US), Main Line Health (US), Abbott Northwestern Hospital (US), Mount Sinai Health System (US), Westchester Medical Center (US), Universität Hamburg (DE), Washington University in St. Louis (US), Cornell University (US), University of Michigan (US), Columbia University Irving Medical Center (US), Morton Plant Hospital (US), Montreal Heart Institute (CA), Lenox Hill Hospital (US), St. Paul's Hospital (CA), Erasmus MC (NL), Copenhagen University Hospital (DK), Rigshospitalet (DK), San Raffaele University of Rome (IT), LMU Klinikum (DE), Yale University (US), St. Francis Hospital (US), Lankenau Heart Institute (US), St. Francis Hospital (US), Presbyterian Hospital (US), University Medical Center Hamburg-Eppendorf (DE), Heart Hospital Baylor Plano (US), Leipzig Heart Institute (DE), Hôpital Cardiologique du Haut-Lévêque (FR), Texas Health Harris Methodist Hospital Fort Worth (US), St. Paul's Hospital (CA), Northwestern Medicine (US), Deutsches Herzzentrum München (DE), GastroZentrum Hirslanden Zürich (CH), University Hospital Cologne (DE), St. Francis Hospital (US), Berlin Heart (Germany) (DE), Ospedali Riuniti Umberto I (IT), Medical University of Vienna (AT), University of Pennsylvania (US), Ludwig-Maximilians-Universität München (DE)
Openalex Percentile: Top 24%
Cardiac Valve Diseases and Treatments
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