AUTHOR=Matta Anthony , Levai Laszlo , Roncalli Jerome , Elbaz Meyer , Bouisset Frederic , Nader Vanessa , Blanco Stephanie , Campelo Parada Francisco , Carrié Didier , Lhermusier Thibault 

TITLE=Comparison of in-hospital outcomes and long-term survival for valve-in-valve transcatheter aortic valve replacement versus the benchmark native valve transcatheter aortic valve replacement procedure

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1113012

DOI=10.3389/fcvm.2023.1113012

ISSN=2297-055X

ABSTRACT=Background: In the recent years, the proportion of patients with failed surgically implanted aortic bio prosthesis and the number of candidates for valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) are increasing. 
Objectives: The purpose of this study is to evaluate the efficacy, safety, and long-term survival of VIV-TAVR with the benchmark native valve transcatheter aortic valve replacement (NV-TAVR). 
Methods: A cohort was conducted on patients who underwent TAVR in the department of cardiology at Toulouse University Hospital, Rangueil, France between January 2016 and January 2020. The study population was divided into two groups: NV-TAVR (N= 1589) and VIV-TAVR (N=69). Baseline characteristics, procedural data, in-hospital outcomes, and long-term survival in September 2022 were collected.  
Results: In comparison with NV-TAVR, there are no differences in TAVR success rate (98.6% vs 98.8%, p=1), per-TAVR complications (p=0.473), and length of hospital stay (7.5±50.7 vs 4.4±2.8, p=0.612). In-hospital outcomes did not differ between study groups including acute heart failure (1.4% vs 1.1%), acute kidney injury (2.6%, 1.4%), stroke (0% vs 1.8%, p=0.630), vascular complications (p=0.307), bleeding events (0.617) and death (1.4% vs 2.6%). VIV-TAVR was associated with higher residual gradient [OR=1.139, 95%CI (1.097-1.182), p= 0.001] and lower permanent pacemaker implantation [OR=0.235 95%CI (0.056-0.990), p=0.048]. No significant difference in survival over a mean follow-up period of 3.44±1.67 year has been observed (p=0.074).
Conclusion: VIV-TAVR represents a safety and efficacy profile like NV-TAVR. It results in better early outcome, but higher non-significant long-term mortality rate.