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Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

56
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
56
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

64
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
64

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Related Experiment Video

Updated: Sep 24, 2025

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Aortic valve versus root surgery after failed transcatheter aortic valve replacement.

Keti Vitanova1, Syed Zaid2, Gilbert H L Tang3

  • 1German Heart Center Munich, Munich, Germany.

The Journal of Thoracic and Cardiovascular Surgery
|May 7, 2022
PubMed
Summary

Outcomes after transcatheter aortic valve replacement (TAVR) explantation showed similar survival rates between aortic valve replacement (AVR) and root replacement. Further research is needed to identify patients needing root replacement post-TAVR explant.

Keywords:
TAVR explantationTAVR failureaortic root replacementsurgical aortic valve replacementtranscatheter aortic valve replacement

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • TAVR explantation may necessitate further surgical intervention, with outcomes for aortic valve replacement (AVR) versus root replacement remaining unclear.

Purpose of the Study:

  • To compare the outcomes of AVR versus root replacement following TAVR explantation.
  • To identify clinical characteristics and anatomical factors influencing the choice between AVR and root replacement after TAVR explantation.

Main Methods:

  • Retrospective review of the EXPLANT-TAVR International Registry (November 2009 - September 2020).
  • Comparison of 168 AVR cases with 28 root replacement cases after TAVR explantation, excluding same-admission explants and concomitant procedures.
  • Outcomes assessed at 30 days and 1 year post-explantation.

Main Results:

  • Patients requiring root replacement had less favorable anatomy for redo TAVR and fewer comorbidities compared to AVR.
  • The median time from initial TAVR to explantation was longer in the root replacement group.
  • No significant differences were observed in overall survival, in-hospital, 30-day, or 1-year mortality and stroke rates between the AVR and root replacement groups.

Conclusions:

  • Despite differing clinical characteristics, AVR and root replacement following TAVR explantation demonstrate comparable short-term mortality and morbidity.
  • Further investigation is required to pinpoint specific patient populations at higher risk for root replacement during TAVR explantation.