Document Type
Article
Publication Title
JACC. Cardiovascular interventions
Abstract
BACKGROUND: Redo-transcatheter aortic valve replacement (TAVR) for failed transcatheter heart valves is expected to increase, but data on outcomes with self-expanding valves remain limited.
OBJECTIVES: The aims of this study were to evaluate procedural, clinical, and quality-of-life outcomes following redo-TAVR using self-expanding Evolut valves and to compare these outcomes with those among a contemporary native TAVR cohort.
METHODS: Outcomes after redo-TAVR with Evolut R, Evolut PRO, and Evolut PRO+ valves in the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry were analyzed and compared with outcomes after native-valve TAVR using the same valve platform during the same study period. The primary endpoints were all-cause mortality, stroke, and readmission at 30 days and 1 year.
RESULTS: Among 439 redo-TAVR patients (mean age 78.9 ± 9.8 years, 63.1% women), procedural complication rates were low. Redo-TAVR reduced transvalvular gradients at 1 year, although gradients remained modestly higher than after native TAVR (11.3 ± 6.1 mm Hg vs 8.2 ± 4.6 mm Hg; P < 0.001). After adjustment, clinical outcomes were similar between redo-TAVR and native TAVR at 30 days (mortality adjusted HR: 0.66 [95% CI: 0.39-1.13; P = 0.129]; stroke adjusted HR: 0.95 [95% CI: 0.54-1.68; P = 0.853]; readmission adjusted HR: 0.88 [95% CI: 0.65-1.20; P = 0.422]) and 1-year (mortality adjusted HR: 0.91 [95% CI: 0.72-1.15; P = 0.441]; stroke adjusted HR: 0.91 [95% CI: 0.63-1.34; P = 0.644]; readmission adjusted HR: 0.92 [95% CI: 0.76-1.13; P = 0.439]). Improvements in functional status and quality of life were observed early after redo-TAVR and were sustained through 1 year. Findings were consistent across prespecified subgroups.
CONCLUSIONS: In a national registry, redo-TAVR with the Evolut platform was associated with low procedural complication rates and clinical outcomes comparable with those observed with native TAVR. These findings support redo-TAVR with Evolut as a feasible and effective treatment strategy in appropriately selected patients.
First Page
2204
Last Page
2216
DOI
10.1016/j.jcin.2026.07.009
Publication Date
8-24-2026
Recommended Citation
Rogers T, Bapat VN, Chetcuti SJ, Dauerman HL, Forrest JK, Goel SS, Grubb KJ, Htun WW, Puri R, Reardon MJ, Tang GHL, Vora AN, Yakubov SJ, Eisenberg R, Attizzani GF. Redo-Transcatheter Aortic Valve Replacement With Self-Expanding Valves: A U.S. Registry Analysis. JACC Cardiovasc Interv. 2026 Aug 24;19(16):2204-2216. doi: 10.1016/j.jcin.2026.07.009. PMID: 42637291.