{"id":6120,"date":"2025-03-25T13:08:22","date_gmt":"2025-03-25T10:08:22","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=6120"},"modified":"2025-03-25T13:08:22","modified_gmt":"2025-03-25T10:08:22","slug":"tavr-for-failing-surgical-valves-lessons-learned-from-new-5-year-data","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/tavr-for-failing-surgical-valves-lessons-learned-from-new-5-year-data\/","title":{"rendered":"TAVR for failing surgical valves: Lessons learned from new 5-year data"},"content":{"rendered":"<div>TAVR for failing surgical valves: Lessons learned from new 5-year data.<\/div>\n<div><\/div>\n<div>Key Points from PARTNER 3 Aortic Valve-in-Valve Study<\/div>\n<div><\/div>\n<div>Conference: Cardiovascular Research Technologies (CRT) March 2025.<\/div>\n<div>Presenter: S. Chris Malaisrie, MD<\/div>\n<div><\/div>\n<div>1. Five-Year Outcomes of Aortic Valve-in-Valve (VIV) TAVR<\/div>\n<div><span> \u2022 The study analyzed 100 low- and intermediate-risk patients who underwent transfemoral TAVR using the Edwards Lifesciences Sapien 3 valve due to failing bioprosthetic valves.<\/span><\/div>\n<div><span> \u2022 The five-year mortality rate was 11%, which is considered favorable.<\/span><\/div>\n<div><span> \u2022 Current U.S. guidelines only approve VIV procedures for high-risk patients, making these findings crucial for expanding treatment in lower-risk groups.<\/span><\/div>\n<div><\/div>\n<div>2. Implications for Lifetime Valve Management<\/div>\n<div><span> \u2022 Many patients undergoing VIV TAVR were initially in their 50s at the time of their first aortic valve replacement, raising concerns about long-term treatment strategies.<\/span><\/div>\n<div><span> \u2022 The findings support a Surgical Aortic Valve Replacement (SAVR) first approach in younger patients, followed by TAVR as a second intervention to maintain future treatment options.<\/span><\/div>\n<div><\/div>\n<div>3. Durability and Hemodynamics of VIV TAVR<\/div>\n<div><span> \u2022 At five years, mean pressure gradients remained at 17-19 mmHg, slightly higher than those observed in native aortic stenosis TAVR cases.<\/span><\/div>\n<div><span> \u2022 Optimization strategies for better outcomes:<\/span><\/div>\n<div><span> \u2022 Performing aortic root enlargement during initial surgery to allow for larger future valves.<\/span><\/div>\n<div><span> \u2022 Ensuring proper valve sizing and positioning to prevent complications like leaflet pinwheeling and malalignment.<\/span><\/div>\n<div><span> \u2022 Creating a larger annulus during surgery to accommodate potential second or third VIV procedures in the future.<\/span><\/div>\n<div><\/div>\n<div>These findings highlight the viability of VIV TAVR in lower-risk patients and emphasize the importance of procedural planning for long-term valve management.<\/div>\n<div><\/div>\n<div>(<span> <\/span>Bioprosthetic (tissue) valves are the primary candidates for valve-in-valve (VIV) TAVR because they can degenerate over time, whereas mechanical valves are designed for durability.<\/div>\n<div>If a mechanical valve fails, the standard approach is re-do surgical aortic valve replacement (SAVR), rather than TAVR).<\/div>\n","protected":false},"excerpt":{"rendered":"<p>TAVR for failing surgical valves: Lessons learned from new 5-year data. Key Points from PARTNER 3 Aortic Valve-in-Valve Study Conference: Cardiovascular Research Technologies (CRT) March 2025. Presenter: S. Chris Malaisrie, MD 1. Five-Year Outcomes of Aortic Valve-in-Valve (VIV) TAVR \u2022 The study analyzed 100 low- and intermediate-risk patients who underwent transfemoral TAVR using the Edwards [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6120","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6120","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=6120"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6120\/revisions"}],"predecessor-version":[{"id":6121,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6120\/revisions\/6121"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=6120"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=6120"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=6120"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}