TAVR in TAVR: Where Are We in 2023 for Management of Failed TAVR Valves?

Curr Cardiol Rep. 2023 Nov;25(11):1425-1431. doi: 10.1007/s11886-023-01959-7. Epub 2023 Oct 10.

Abstract

Purpose of review: As TAVR is increasingly performed on younger patients with a longer life expectancy, the number of redo-TAVR procedures is likely to increase in the coming years. Limited data is currently available on this sometimes challenging procedure. We provide a summary of currently published literature on management of patients with a failed transcatheter aortic valve.

Recent findings: Recent registry data have increased the clinical knowledge on redo-TAVR. Additionally, numerous bench studies have provided valuable insights into the technical aspects of redo-TAVR with various combinations of valve types. Redo-TAVR can be performed safely in selected cases with a high procedural success and good short-term outcomes. However, at present, the procedure remains relatively infrequent and many patients are not eligible. Bench testing can be useful to understand important concepts such as valve expansion, neoskirt, leaflet overhang, and leaflet deflection as well as their potential clinical implications.

Keywords: Leaflet overhang; Neoskirt; Redo-TAVR; TAVI; TAVR.

Publication types

  • Review

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Heart Valve Prosthesis*
  • Humans
  • Prosthesis Design
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / methods
  • Treatment Outcome