Durability of Bioprosthetic Surgical Aortic Valves in Patients Who Underwent Transcatheter Valve-in-Valve Implantation

Bioprosthetic valves for surgical aortic valve (AV) replacement (SAVR) have increased in popularity in the past decades.1 Several studies have been conducted to compare the durability of different bioprosthetic valves; however, a former systematic review of 167 studies and 12 Food and Drug Administration reports concluded that reporting bioprosthetic valve durability in the literature is characterized by variable definitions and inadequate long-term follow-up, making the comparison between different valves difficult.2 In our study, we performed a retrospective review of patients who underwent valve-in-valve transcatheter AV implantation (ViV-TAVI) for failed bioprosthetic valves. Structural valve deterioration (SVD) was defined according to VARC-2 criteria as the increase in mean transvalvular gradient ≥20 mm Hg with concomitant decrease in AV area ≥0.6 cm2 and/or decrease in Doppler velocity index ≥0.2 compared with post-procedure echocardiographic assessment.3 Valve dysfunction was classified into three distinct groups (prosthetic AV stenosis, AV insufficiency, and mixed aortic stenosis [AS]/aortic insufficiency [AI]). [...]homograft and pericardial stented valves had the longest valve durability in patients who underwent ViV-TAVI for failed surgical valves.Disclosures The authors have no conflicts of interest to declare.Acknowledgment This study was made possible by a generous gift from Jennifer and Robert McNeil.