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Updated: Jun 11, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Outcomes of Unplanned Additional Transcatheter Aortic Valve Deployment
Eduardo Gabriel Danduch1, Nikhil Azhagiri1, Mei Zuo1
1Albany Medical College, Albany, New York.
Annals of Thoracic Surgery Short Reports
|June 10, 2026
Summary
Unplanned additional transcatheter aortic valve replacement (TAVR) valve deployment for complications like severe AI or embolization is feasible. However, this procedure may increase the need for permanent pacemaker placement.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Complications after transcatheter aortic valve replacement (TAVR), including significant residual aortic insufficiency (AI), paravalvular leak, or valve embolization, may necessitate an unplanned additional TAVR valve deployment.
- Outcomes following unplanned additional valve deployment are not well-documented, highlighting a need for further investigation.
Purpose of the Study:
- To evaluate the postoperative outcomes of patients who required an unplanned additional TAVR valve deployment.
- To assess the safety and efficacy of a second TAVR valve implantation in managing TAVR-related complications.
Main Methods:
- A retrospective review of 1131 patients who underwent TAVR between January 2021 and September 2023.
- Analysis of data from patients requiring an unplanned second TAVR valve deployment, focusing on indications, procedural success, and short-term outcomes.
Main Results:
- Nine patients (0.8%) required an unplanned additional TAVR valve deployment, primarily for severe AI (66.7%), valve embolization (22.2%), or improper valve position (11.1%).
- AI was resolved in all but one patient, who died post-procedure. Permanent pacemaker placement was required in 22% of patients. Thirty-day mortality varied by indication, with 16.7% in the severe AI group.
- Cumulative survival rates were 88.9% at 1 month and 71.1% at 12 months, with no repeat aortic valve interventions during follow-up.
Conclusions:
- Unplanned additional valve deployment in TAVR can achieve satisfactory outcomes in managing complications.
- This intervention may be associated with an increased risk of permanent pacemaker placement.
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