To compare early and midterm outcomes of transcatheter valve-in-valve implantation (ViV-TAVI) and redo surgical aortic valve replacement (re-SAVR) for aortic bioprosthetic valve degeneration. Patients who underwent ViV-TAVI and re-SAVR for aortic bioprosthetic valve degeneration between January 2010 and October 2018 were retrospectively analyzed. Mean follow-up was 3.0 years. In-hospital, early, and mid-term outcomes. Eighty-eight patients were included in the analysis. Thirty-one patients (37.3%) had ViV-TAVI, and 57 patients (62.7%) had re-SAVR. In the ViV-TAVI group, patients were older (79.1 ± 7.4 v 67.2 ± 14.1, p < 0.01). The total operative time, intubation time, intensive care unit length of stay, total hospital length of stay, inotropes infusion, intubation >24 hours, total amount of chest tube losses, red blood cell transfusions, plasma transfusions, and reoperation for bleeding were significantly higher in the re-SAVR cohort (p < 0.01). There was no difference regarding in-hospital permanent pacemaker implantation (ViV-TAVI=3.2% v re-SAVR=8.8%, p=0.27), patient-prosthesis mismatch (ViV-TAVI=12 patients [mean 0.53 ± 0.07] and re-SAVR=ten patients [mean 0.56 ± 0.08], p=0.4), stroke (ViV-TAVI=3.2% v re-SAVR=7%, p=0.43), acute kidney injury (ViV-TAVI=9.7% v re-SAVR=15.8%, p=0.1), and all-cause infections (ViV-TAVI=0% v re-SAVR=8.8%, p=0.02), between the two groups. In-hospital mortality was 0% and 7% for ViV-TAVI and re-SAVR, respectively (p=0.08). At three-years' follow-up, the incidence of pacemaker implantation was higher in the re-SAVR group (ViV-TAVI=0 v re-SAVR=13.4%, p < 0.01). There were no differences in reintervention (ViV-TAVI=3.8% v re-SAVR=0%, p=0.32) and survival (ViV-TAVI=83.9% v re-SAVR=93%, p=0.10) between the two cohorts. ViV-TAVI is a safe, feasible, and reliable procedure.
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