Maxwell C Braasch,Sophia R Pyeatte,June He,Mehran Rahimi,Alexander A Brescia,Puja Kachroo,Harold G Roberts,Nathan Frogge,Nishath Quader,Marc A Sintek,Alan Zajarias,Nicholas Kouchoukos,Tsuyoshi Kaneko
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引用次数: 0
Abstract
Importance
Transcatheter aortic valve replacement (TAVR) reintervention is performed by either redo TAVR or TAVR explant. There is insufficient data on contemporary TAVR reintervention procedural incidence and volume.
Objective
To evaluate contemporary procedural volumes of redo TAVR and TAVR explant.
Design, Setting, and Participants
This retrospective analysis of redo TAVR and TAVR explant annual incidence and procedural volume was performed from January 2012 to June 2024. For comprehensive assessment of aortic valve replacement, analysis of SAVR reintervention annual incidence and procedural volume was also performed. Data were obtained through the US Centers for Medicare & Medicaid Services Virtual Research Data Center. Patients with prior TAVR or SAVR who underwent subsequent TAVR or SAVR were included.
Exposures
Patients who underwent a TAVR after TAVR defined the redo TAVR group, while patients who underwent SAVR after TAVR defined the TAVR explant group. Patients who underwent a TAVR after SAVR defined the valve-in-valve (ViV) TAVR group, while patients who underwent SAVR after SAVR defined the redo SAVR group. Analysis of annual incidences and procedural volumes of all groups at different time intervals was conducted.
Main Outcomes and Measures
The primary outcome was annual incidence and procedural volume of both redo TAVR and TAVR explant. The secondary outcome was annual incidence and procedural volume of both ViV TAVR and redo SAVR.
Results
Of 410 720 total TAVRs from 2012 to 2024, 2374 redo TAVRs and 1346 TAVR explants were identified. Of 299 780 total SAVRs from 2012 to 2024, 5044 ViV-TAVRs and 4202 redo SAVRs were identified. Since 2020, there have been 1518 redo TAVRs and 1007 TAVR explants. The annual incidence of TAVR reintervention has changed from 0.17% in 2019 to 0.28% in 2023. Although the most common time interval for redo TAVR after index TAVR was within 3 months (410 of 2374 [17.3%]) and for TAVR explant after index TAVR was 1 to 2 years (259 of 1346 [19.2%]), redo TAVR was the predominant procedure beyond 5 years from the index TAVR (725 of 819 [88.5%]).
Conclusions and Relevance
In this study, annual volumes of both redo TAVR and TAVR explant continued to increase, particularly in recent years. Redo TAVR is frequently performed over 5 years from the index TAVR. Future analysis to determine the appropriate TAVR reintervention strategy for individual patients is needed.
JAMA cardiologyMedicine-Cardiology and Cardiovascular Medicine
CiteScore
45.80
自引率
1.70%
发文量
264
期刊介绍:
JAMA Cardiology, an international peer-reviewed journal, serves as the premier publication for clinical investigators, clinicians, and trainees in cardiovascular medicine worldwide. As a member of the JAMA Network, it aligns with a consortium of peer-reviewed general medical and specialty publications.
Published online weekly, every Wednesday, and in 12 print/online issues annually, JAMA Cardiology attracts over 4.3 million annual article views and downloads. Research articles become freely accessible online 12 months post-publication without any author fees. Moreover, the online version is readily accessible to institutions in developing countries through the World Health Organization's HINARI program.
Positioned at the intersection of clinical investigation, actionable clinical science, and clinical practice, JAMA Cardiology prioritizes traditional and evolving cardiovascular medicine, alongside evidence-based health policy. It places particular emphasis on health equity, especially when grounded in original science, as a top editorial priority.