PMID- 37762811 OWN - NLM STAT- Publisher LR - 20230930 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 18 DP - 2023 Sep 9 TI - Incidence and Outcomes of Valve-in-Valve Transcatheter Aortic Valve Implantation in Failed Bioprosthetic Valves. LID - 10.3390/jcm12185868 [doi] LID - 5868 AB - INTRODUCTION: Transcatheter aortic valve replacement (TAVR) has become a widely used, comparably efficient and safe alternative to surgical aortic valve replacement (SAVR). Its utilization continues to grow, especially among younger patients. Despite improvements in durability, degeneration and subsequent re-interventions of failed prosthetic valves are still common. Even though valve-in-valve procedures have become more frequent, little is known about the trends over time or about clinical and echocardiographic long-term outcomes. MATERIALS AND METHODS: Patients who underwent a valve-in-valve procedure between December 2011 and December 2022 in a large tertiary university hospital were analyzed. Primary outcomes were defined as procedural and device successes as well as event-free survival. Secondary analyses between subsets of patients divided by index valve and date of procedure were performed. RESULTS: Among 1407 procedures, 58 (4%) were valve-in-valve interventions, with an increased frequency observed over time. Overall, technical success was achieved in 88% and device success in 85% of patients. Complications were predominantly minor, with similar success rates among TAVR-in-SAVR (TiSAVR) and TAVR-in-TAVR (TiTAVR). Notably, there were significant and lasting improvements in mean echocardiographic gradients at 1 year. Event-free survival was 76% at one month and 69% at one year. CONCLUSIONS: Over the last decade, a rising trend of valve-in-valve procedures was observed. Despite an increase in procedures, complications show a contrasting decline with improved technical and device success over time. TiSAVR and TiTAVR showed comparable rates of procedural and device success as well as similar outcomes, highlighting the utility of valve-in-valve procedures in an aging population. FAU - Stolte, Thorald AU - Stolte T AUID- ORCID: 0000-0001-9840-7818 AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. AD - Department of Health Sciences and Technology, Swiss Federal Institute of Technology, 8092 Zurich, Switzerland. FAU - Boeddinghaus, Jasper AU - Boeddinghaus J AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. AD - British Heart Foundation, University Centre for Cardiovascular Science, Usher Institute, University of Edinburgh, Edinburgh EH16 4SS, UK. FAU - Allegra, Giampiero AU - Allegra G AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. FAU - Leibundgut, Gregor AU - Leibundgut G AUID- ORCID: 0000-0002-0122-5397 AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. FAU - Reuthebuch, Oliver AU - Reuthebuch O AUID- ORCID: 0000-0003-1386-0686 AD - Department of Cardiac Surgery, University Hospital Basel, University of Basel, 4031 Basel, Switzerland. FAU - Kaiser, Christoph AU - Kaiser C AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. FAU - Muller, Christian AU - Muller C AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. FAU - Nestelberger, Thomas AU - Nestelberger T AUID- ORCID: 0000-0003-2173-5738 AD - Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. AD - British Heart Foundation, University Centre for Cardiovascular Science, Usher Institute, University of Edinburgh, Edinburgh EH16 4SS, UK. LA - eng PT - Journal Article DEP - 20230909 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10531770 OTO - NOTNLM OT - transcatheter aortic valve implantation OT - valve prosthesis degeneration OT - valve-in-valve COIS- Thomas Nestelberger has received research support from the Swiss National Science Foundation (P400PM_191037/1), the Prof. Dr. Max Cloetta Foundation, the Margarete und Walter Lichtenstein-Stiftung (3MS1038), and the University Hospital Basel as well as speaker honoraria/consulting honoraria from Edwards Lifesciences, Siemens, Beckman Coulter, Bayer, Ortho Clinical Diagnostics and Orion Pharma, outside the submitted work. Boeddinghaus has received research grants from the University of Basel, the University Hospital of Basel, the Division of Internal Medicine, the Swiss Academy of Medical Sciences, the Gottfried and Julia Bangerter-Rhyner Foundation, the Swiss National Science Foundation (P500PM_206636), and speaker/consulting honoraria or travel support from Siemens, Roche Diagnostics, Ortho Clinical Diagnostics, Quidel Corporation, Beckman Coulter, and Medtronic. All other authors declare that they have no conflicts of interest with this study. All authors critically reviewed the manuscript and approved the final version for submission. The manuscript and its contents have not been published previously and are not being considered for publication elsewhere in whole or in part in any language, including publicly accessible web sites or e-print servers. EDAT- 2023/09/28 06:42 MHDA- 2023/09/28 06:42 PMCR- 2023/09/09 CRDT- 2023/09/28 01:22 PHST- 2023/07/05 00:00 [received] PHST- 2023/07/28 00:00 [revised] PHST- 2023/09/06 00:00 [accepted] PHST- 2023/09/28 06:42 [medline] PHST- 2023/09/28 06:42 [pubmed] PHST- 2023/09/28 01:22 [entrez] PHST- 2023/09/09 00:00 [pmc-release] AID - jcm12185868 [pii] AID - jcm-12-05868 [pii] AID - 10.3390/jcm12185868 [doi] PST - epublish SO - J Clin Med. 2023 Sep 9;12(18):5868. doi: 10.3390/jcm12185868.