Redo SAVR (Surgical Aortic Valve Replacement) After Failed TAVR: Higher Risk but Feasible Option.
Redo SAVR
(Surgical Aortic Valve Replacement) After Failed TAVR: Higher Risk but Feasible Option.
Source: The Annals of Thoracic Surgery – University of Alabama at Birmingham (UAB)
Date: 2025
Key Summary:
1. Background:
• Redo-TAVR is not always feasible when a transcatheter valve fails.
• TAVR explantation followed by surgical aortic valve replacement (SAVR) is being performed more frequently, though it remains a high-risk surgical procedure—often considered twice as complex as standard SAVR.
2. Study Data (UAB):
• From over 2,000 TAVR patients, 33 underwent TAVR explant followed by SAVR.
• Average age: 75 years; STS-PROM score: 5.49%.
• Most common indication: bioprosthetic valve degeneration.
3. Surgical Approach:
• All surgeries were performed via median sternotomy with cardiopulmonary bypass and myocardial arrest using cardioplegia.
• No Bentall procedures required; aortic root repair was performed in 3 cases.
4. Outcomes:
• Survival rates: 94% at 30 days, 81.4% at 1 year, and 61.6% at 3 years.
• Perioperative mortality: 6% (2 deaths).
• Average hospital length of stay: 10 days.
5. Clinical Insight:
• These represent some of the best short- and mid-term outcomes published to date for this very high-risk patient population.
• The results underscore the importance of surgical expertise, multidisciplinary planning, and tailored postoperative care.
