{"id":7213,"date":"2025-05-29T11:13:30","date_gmt":"2025-05-29T08:13:30","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7213"},"modified":"2025-05-29T11:13:30","modified_gmt":"2025-05-29T08:13:30","slug":"surgeons-report-favorable-outcomes-for-high-risk-tavr-explant-and-savr-patients","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/surgeons-report-favorable-outcomes-for-high-risk-tavr-explant-and-savr-patients\/","title":{"rendered":"Surgeons Report Favorable Outcomes for High-Risk TAVR Explant and SAVR Patients"},"content":{"rendered":"
Surgeons Report Favorable Outcomes for High-Risk TAVR Explant and SAVR Patients<\/div>\n
Date: May 12, 2025 | Source: The Annals of Thoracic Surgery.<\/div>\n
1. Background:<\/span><\/div>\n
\u2022 When a TAVR valve fails, redo TAVR is not always possible. In such cases, surgical explant of the TAVR valve followed by surgical aortic valve replacement (SAVR) is often required\u2014though it carries significant risks.<\/span><\/div>\n
2. Study Overview (UAB Experience):<\/span><\/div>\n
\u2022 Surgeons at the University of Alabama at Birmingham (UAB) analyzed data from 33 high-risk patients (mean age 75) who underwent TAVR explantation + SAVR.<\/span><\/div>\n
\u2022 These patients were part of a larger group of 2,000+ who had previously undergone TAVR.<\/span><\/div>\n
\u2022 Indications for explant included:<\/span><\/div>\n
\u2022 Bioprosthetic degeneration<\/span><\/div>\n
\u2022 Endocarditis<\/span><\/div>\n
\u2022 Severe paravalvular leak<\/span><\/div>\n
\u2022 Ventricular septal defect<\/span><\/div>\n
\u2022 All patients were ineligible for redo TAVR per heart team evaluation.<\/span><\/div>\n
3. Procedural Details:<\/span><\/div>\n
\u2022 All surgeries were performed via median sternotomy, with standard bypass, myocardial protection, and explant techniques (e.g., \u201cpeel-away\u201d or \u201croll\u201d method).<\/span><\/div>\n
\u2022 Only bioprosthetic SAVR valves were used.<\/span><\/div>\n
\u2022 No Bentall procedures were needed; root repair was required in 3 cases.<\/span><\/div>\n
4. Outcomes:<\/span><\/div>\n
\u2022 30-day survival: 94%<\/span><\/div>\n
\u2022 1-year survival: 81.4%<\/span><\/div>\n
\u2022 3-year survival: 61.6%<\/span><\/div>\n
\u2022 Perioperative mortality: 6%<\/span><\/div>\n
\u2022 Average hospital stay: 10 days<\/span><\/div>\n
\u2022 The TAVR explant rate at UAB was 1.3%, in line with published data (0.5\u20132%).<\/span><\/div>\n
5. Clinical Implications:<\/span><\/div>\n
\u2022 Despite the high-risk nature of these patients, the team reported some of the best short- and mid-term survival results to date.<\/span><\/div>\n
\u2022 Success was attributed to:<\/span><\/div>\n
\u2022 Careful patient selection and optimization<\/span><\/div>\n
\u2022 Surgical efficiency and simplicity<\/span><\/div>\n
\u2022 Focused postoperative management<\/span><\/div>\n
\u2022 Outcomes were worse when mitral surgery was combined with explant.<\/span><\/div>\n
6. Conclusion:<\/span><\/div>\n
\u2022 As TAVR volumes rise, surgical teams must adapt to the growing need for explantation procedures.<\/span><\/div>\n
\u2022 Institutional experience and understanding of cohort-specific risk factors are key to improving safety and outcomes.<\/span><\/div>\n
https:\/\/www.annalsthoracicsurgery.org\/article\/S0003-4975(25)00407-2\/abstract<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

Surgeons Report Favorable Outcomes for High-Risk TAVR Explant and SAVR Patients Date: May 12, 2025 | Source: The Annals of Thoracic Surgery. 1. Background: \u2022 When a TAVR valve fails, redo TAVR is not always possible. In such cases, surgical explant of the TAVR valve followed by surgical aortic valve replacement (SAVR) is often required\u2014though […]<\/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-7213","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7213","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=7213"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7213\/revisions"}],"predecessor-version":[{"id":7214,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7213\/revisions\/7214"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7213"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7213"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}