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Updated: Jan 16, 2026
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Surgical Aortic Valve Replacement Following TAVR: Long-Term Comparative Outcomes Versus Non-SAVR Cardiac Surgery
Osamah Badwan1, Issam Motairek1, Fawzi Zghyer1
1Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH.
Background:
As TAVR use expands, some patients require later cardiac surgery, including SAVR with TAVR valve explant in certain scenarios. The long-term risks of SAVR after TAVR compared with other cardiac surgeries remain unclear.
Methods:
We studied adults in the TriNetX network who underwent TAVR followed by either SAVR or non-SAVR open-heart surgery (OHS) between 2010 and 2023. Propensity-score matching was done on 26 clinical and demographic factors. We compared outcomes at 3 and 5 years.
Results:
After matching, 132 patients were included in each group. The groups were well-balanced at baseline. At 3 years, mortality was similar (18.9% SAVR vs 22.0% OHS; HR: 0.83, 95% CI: 0.46 to 1.51). At 5 years, mortality remained comparable (20.5% vs 24.2%; OR: 0.80, 95% CI 0.45 to 1.44). Rates of stroke, acute coronary syndrome, heart failure hospitalization, major bleeding, new atrial fibrillation, and renal failure were also similar.
Conclusions:
SAVR after TAVR was associated with similar long-term outcomes compared with OHS. These findings suggest that risks may be more related to patient complexity than to the valve explant itself.
