Reintervention rarely occurs after TAVR

Reintervention following transcatheter aortic valve replacement (TAVR) is few and far between and is usually done early after the procedure and by redo TAVR, according to a study.

The analysis included 72,850 patients who had a TAVR between 2010 and 2022 recorded in the FRANCE 2 and FRANCE TAVI registries. The researchers assessed the cumulative incidence of early (≤1 year) and late (>1 year) reintervention using the Kalbfleisch and Prentice method to account for all-cause death as a competing risk.

Patients who had reintervention for infective endocarditis were excluded from the study. Finally, Kaplan-Meier analysis was carried out to assess long-term mortality.

At 8 years, the cumulative incidence of overall reintervention among patients was 1.7 percent. Of these, 591 had redo TAVR and 111 required explant TAVR with a low incidence of Bentall intervention. Reintervention mostly occurred early in 62.1 percent of patients. It also happened more frequently in those who had a mean aortic gradient >20 mm Hg immediately after index TAVR.

The following factors were associated with reintervention: age and mean aortic gradient before TAVR and mean aortic gradient >20 mm Hg, aortic regurgitation grade ≥2, and percutaneous coronary intervention after TAVR.

Mortality at 6 years was high but did not differ significantly between patients who had early and late reintervention (76.2 percent vs 64.0 percent; p=0.77).

“Further studies are warranted, particularly in younger patients with longer life expectancy,” the researchers said.