Related Experiment Video
Updated: Feb 18, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Redo versus first transcatheter aortic valve implantation: A propensity score-matched analysis
Pierre Deharo1, Ferdinando Sabatino2, Christophe Saint Etienne3
1Department of Cardiology, CHU Timone, 13005 Marseille, France; C2VN, Aix-Marseille University, INSERM, INRA, 13005 Marseille, France.
Background:
Redo transcatheter aortic valve implantation (TAVI) is increasingly used to treat bioprosthetic valve dysfunction in patients who have undergone TAVI. As TAVI indications continue to expand to include younger patients, it is essential to systematically document redo TAVI procedures to better understand their long-term efficacy and safety. This study aimed to compare outcomes between redo TAVI and first TAVI procedures using a propensity score-matched analysis.
Aims:
To compare the long-term clinical outcomes, including death, stroke and procedural adverse events, between redo TAVI and first TAVI procedures using a propensity score-matched analysis.
Methods:
A retrospective analysis was conducted using the TriNetX database, identifying adults (≥18years) with severe aortic stenosis who underwent TAVI (2012-2024). Redo TAVI required an interval of ≥12months. Propensity score matching was performed using all baseline characteristics listed in Table 1, with outcomes assessed over 36months.
Results:
After matching, 446 patients were included in each cohort. No statistically significant difference was observed in the annual rates of all-cause death (11.3% vs 8.7%; hazard ratio 1.20, 95% confidence interval 0.86-1.68), ischaemic stroke (hazard ratio 2.07, 95% confidence interval 0.99-4.35) or major bleeding (hazard ratio 1.41, 95% confidence interval 0.99-2.02) between the redo TAVI and first TAVI groups. Pacemaker implantation (hazard ratio 0.25, 95% confidence interval 0.12-0.51), new-onset atrial fibrillation (hazard ratio 0.44, 95% confidence interval 0.24-0.79) and hospitalization for heart failure (hazard ratio 0.64, 95% confidence interval 0.41-0.99) were significantly lower in the redo TAVI group.
Conclusions:
No statistically significant difference was observed in all-cause death, ischaemic stroke or major bleeding between the redo TAVI and first TAVI groups. Conversely, redo TAVI was associated with significantly lower rates of permanent pacemaker implantation and heart failure rehospitalization. These findings support the integration of redo TAVI as an essential component within a comprehensive lifetime treatment strategy for managing bioprosthetic aortic valve dysfunction.
