Redo transcatheter aortic valve replacement in degenerated transcatheter bioprosthesis (TAV-in-TAV).

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-10-26 DOI:10.1080/14779072.2023.2266368

Juan Sánchez-Ceña, Lluis Asmarats, Chi Hion Pedro Li, Xavier Millán, Estefanía Fernández-Peregrina, Irene Menduiña, Albert Massó van Roessel, Dabit Arzamendi

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Abstract

Introduction: With the expanding indications of transcatheter aortic valve replacement (TAVR) to younger and low-risk patients, the life expectancy of patients currently undergoing TAVR will likely outlive the durability of transcatheter bioprosthesis. Consequently, the number of failed transcatheter bioprosthesis requiring surgical valve explant or redo TAVR is expected to increase.

Areas covered: The aim of this review is to provide an updated overview of redo TAVR for treating degenerated transcatheter bioprosthesis, focusing on pre-procedural planning, potential challenges of coronary reaccess during TAVR-in-TAVR and main outcomes of TAVR explant and redo TAVR.

Expert opinion: Patient-tailored device selection and individualized implantation height should be carefully assessed during the index TAVR procedure (weighting between pacemaker avoidance and the potential risk of coronary occlusion in future TAVR-in-TAVR). Future prospective studies comparing safety and clinical outcomes between redo TAVR vs TAVR explant are eagerly awaited.

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在退化的经导管生物瓣膜（TAV中的TAV）中恢复经导管主动脉瓣置换术。

引言：随着经导管主动脉瓣置换术（TAVR）的适应症向年轻和低风险患者扩展，目前接受TAVR的患者的预期寿命可能会超过经导管生物瓣膜的耐用性。因此，需要外科瓣膜移植或重新进行TAVR的经导管生物瓣膜的失败数量预计会增加。涵盖的领域：本综述的目的是提供治疗退化的经导管生物瓣膜的重做TAVR的最新概述，重点是术前规划，TAVR中TAVR期间冠状动脉再通的潜在挑战以及TAVR外植体和重做TAVR的主要结果。专家意见：在指数TAVR过程中，应仔细评估患者定制的装置选择和个性化植入高度（在避免起搏器和TAVR中未来TAVR中冠状动脉闭塞的潜在风险之间进行加权）。人们热切期待着未来对重做TAVR与TAVR外植体的安全性和临床结果进行比较的前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

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0.00%

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期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.