Work

Surgical Aortic Valve Replacement Following TAVR: Long-Term Comparative Outcomes Versus Non-SAVR Cardiac Surgery

Year: 2025

Type: article

Abstract: 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.

Source: The American Journal of Cardiology

DOI: 10.1016/j.amjcard.2025.09.009