Surgical Explantation of Transcatheter Aortic Valve Requires Patient-Tailored Management, but Challenges Remain

Transcatheter aortic valve replacement has become a widely accepted alternative to surgical aortic valve replacement even in younger, lower-risk patients with longer life expectancy. The increasing use of transcatheter aortic valve replacement is leading to a rise in the need for surgical explantation of failing transcatheter valves, a complex procedure associated with increased periprocedural risks and technical challenges. The absence of established guidelines for the treatment of this life-threatening condition highlights an important clinical challenge. Published experience with surgical explantation of transcatheter aortic valve remains limited. Standardized explanation protocols, patient-tailored management, careful patient selection, detailed preoperative imaging, and early surgical referral are essential for improving safety and efficacy. Optimal outcomes require collaboration among cardiac surgeons, cardiologists, infectious disease specialists, and radiologists.