Redo‐transcatheter aortic valve replacement with the supra‐annular, self‐expandable Evolut platform: Insights from the Transcatheter valve Therapy Registry

Abstract

AbstractObjectivesTo assess the safety profile of redo‐TAVR procedures from patients in the transcatheter valve therapy (TVT) Registry.BackgroundThe use of transcatheter aortic valves (TAV) to treat previously implanted failing TAVS (TAV‐in‐TAV) has been an increasingly important topic as indications for TAVR move to younger and lower‐risk patients, but data on the safety and efficacy of redo‐TAVR is limited.MethodsPatients undergoing redo‐TAVR procedures using the Evolut R, Evolut PRO or Evolut PRO+ valve in the TVT Registry between April 2015 and March 2020 were included. In‐hospital, 30‐day and 1‐year outcomes were analyzed.ResultsRedo‐TAVR was performed in 292 patients (213 patients received the Evolut R valve and 79 received the Evolut PRO or PRO+ valve). Device success was achieved in 94.5%. In‐hospital mortality was 2.1%, stroke occurred in 2.7%, and 77.2% of patients were discharged home. There were no cases of coronary compression/obstruction or myocardial infarction that occurred in index hospitalization. Mean gradient at 30‐days was 11.9 ± 6.9 mmHg, and 73.1% had none/trace total aortic regurgitation.ConclusionsResults from the TVT Registry demonstrate good short‐term outcomes after redo‐TAVR with the supra‐annular, self‐expandable Evolut platform. Long‐term follow‐up is necessary to further expand understanding this complex scenario.