Redo versus first transcatheter aortic valve implantation: A propensity score-matched analysis - 15/02/26
, Ferdinando Sabatino a, Christophe Saint Etienne c, Jeremy Boyer a, Anne Bernard c, d, Thierry Bourguignon d, e, Carl Semaan c, Jean Michel Clerc c, Thomas Cuisset a, b, Laurent Fauchier cGraphical abstract |
Highlights |
• | Study conducted using the TriNetX database (covering 135 healthcare organizations) |
• | More than 60,000 patients who had a first TAVI or redo TAVI were analysed. |
• | Propensity score matching produced two comparable groups, each with 446 patients. |
• | Redo TAVI showed higher but non-significant death, stroke and bleeding risks. |
• | Pacemaker implantation was significantly lower after redo TAVI. |
• | New-onset atrial fibrillation occurred less frequently after redo TAVI. |
• | Redo TAVI was associated with fewer heart failure hospitalizations. |
Abstract |
Background |
Redo transcatheter aortic valve implantation (TAVI) is increasingly used to treat bioprosthetic valve dysfunction in patients who have undergone TAVI. As TAVI indications continue to expand to include younger patients, it is essential to systematically document redo TAVI procedures to better understand their long-term efficacy and safety. This study aimed to compare outcomes between redo TAVI and first TAVI procedures using a propensity score-matched analysis.
Aims |
To compare the long-term clinical outcomes, including death, stroke and procedural adverse events, between redo TAVI and first TAVI procedures using a propensity score-matched analysis.
Methods |
A retrospective analysis was conducted using the TriNetX database, identifying adults (≥ 18 years) with severe aortic stenosis who underwent TAVI (2012–2024). Redo TAVI required an interval of ≥ 12 months. Propensity score matching was performed using all baseline characteristics listed in Table 1, with outcomes assessed over 36 months.
Results |
After matching, 446 patients were included in each cohort. No statistically significant difference was observed in the annual rates of all-cause death (11.3% vs 8.7%; hazard ratio 1.20, 95% confidence interval 0.86–1.68), ischaemic stroke (hazard ratio 2.07, 95% confidence interval 0.99–4.35) or major bleeding (hazard ratio 1.41, 95% confidence interval 0.99–2.02) between the redo TAVI and first TAVI groups. Pacemaker implantation (hazard ratio 0.25, 95% confidence interval 0.12–0.51), new-onset atrial fibrillation (hazard ratio 0.44, 95% confidence interval 0.24–0.79) and hospitalization for heart failure (hazard ratio 0.64, 95% confidence interval 0.41–0.99) were significantly lower in the redo TAVI group.
Conclusions |
No statistically significant difference was observed in all-cause death, ischaemic stroke or major bleeding between the redo TAVI and first TAVI groups. Conversely, redo TAVI was associated with significantly lower rates of permanent pacemaker implantation and heart failure rehospitalization. These findings support the integration of redo TAVI as an essential component within a comprehensive lifetime treatment strategy for managing bioprosthetic aortic valve dysfunction.
Le texte complet de cet article est disponible en PDF.Keywords : TAVI, Redo-TAVI, Aortic stenosis
Abbreviations : BVD, CI, HR, ICD-10, MI, SAVR, TAVI
Plan
Vol 119 - N° 1
P. 25-31 - janvier 2026 Retour au numéro
Article précédent
- The STRAT clinical risk score to predict early ischaemic stroke post-TAVI: The FRANCE-TAVI registry
- Matthieu Besutti, Romain Chopard, Fiona Ecarnot, Manon Leclère, Hélène Eltchaninoff, Bernard Iung, Martine Gilard, Philippe Commeau, Mariama Akodad, Hakim Benamer, Sylvain Beurtheret, Thomas Cuisset, Hervé Le Breton, Eric Van Belle, Jean-Philippe Verhoye, Guillaume Cayla, François Schiele, Maxime Desmarets, Nicolas Meneveau, RHU STOP-AS, France-TAVI Investigators
- Cardiac remodelling in aortic stenosis
- Marie-Annick Clavel, Lionel Tastet, Philippe Pibarot
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