Comparing short- and long-term outcomes of transcatheter valve-in-valve versus redo surgical aortic valve replacement: a literature review.
Ebrahimi, Pouya Eshraghi, Reza Moradi, Ali Javid, Roozbeh Narimani Khalique, Omar Darouei, Bahar Rafiei, Nazanin Kampaktsis, Polydoros Spilias, Nikolaos Siegel, Robert
Ebrahimi, Pouya
Eshraghi, Reza
Moradi, Ali
Javid, Roozbeh Narimani
Khalique, Omar
Darouei, Bahar
Rafiei, Nazanin
Kampaktsis, Polydoros
Spilias, Nikolaos
Siegel, Robert
Abstract
Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) and redo-surgical aortic valve replacement (redo-SAVR) are two primary strategies for managing degenerated bioprosthetic aortic valves. ViV-TAVR has gained prominence due to its minimally invasive nature, shorter recovery time, and reduced perioperative risk, making it preferable for high-risk patients with multiple comorbidities. In contrast, redo-SAVR remains the gold standard for younger, lower-risk patients because of its superior long-term durability, lower residual gradients, and decreased risk of patient-prosthesis mismatch (PPM). ViV-TAVR and redo-SAVR are key strategies for managing degenerated bioprosthetic aortic valves. ViV-TAVR is favored for high-risk patients due to its minimally invasive nature, shorter recovery, and reduced perioperative risks, while redo-SAVR remains the gold standard for younger, lower-risk patients owing to its long-term durability and reduced risk of patient-prosthesis mismatch. Ongoing concerns regarding long-term durability, higher transvalvular gradients, and potential coronary obstruction exist. Although redo-SAVR offers better longevity, it has higher perioperative risks and longer recovery times. Across the included propensity-score matched studies and meta-analyses, long-term all-cause mortality was generally comparable between ViV-TAVR and redo-SAVR, although results were heterogeneous and some studies suggested a possible advantage for redo-SAVR in selected populations and/or with longer follow-up. However, ViV-TAVR may be associated with increased heart failure hospitalizations (HHF) after two years and redo-SAVR has superior short-term outcomes with regard to decreased myocardial infarction and PPM. Comparative studies also highlight a lower risk of atrial fibrillation (AF) and major adverse cardiovascular events (MACE) with ViV-TAVR, while redo-SAVR patients may experience better mid- to long-term survival.
MIDER Authors
Affiliations
Date
2026-05-22
Type
Article
Subject
Collections
Citation
Ebrahimi P, Eshraghi R, Moradi A, Javid RN, Khalique O, Darouei B, Rafiei N, Kampaktsis P, Spilias N, Siegel R, Fogli M, Taheri H, Mandegar MH, Kumar H, Taheri M, Hosseini K. Comparing short- and long-term outcomes of transcatheter valve-in-valve versus redo surgical aortic valve replacement: a literature review. J Cardiothorac Surg. 2026 May 22. doi: 10.1186/s13019-026-04105-w.