Evidence map›Paper›PMID 33719506›Full record

ArticleCirculation. Cardiovascular interventions2021

Surgical Explantation of Transcatheter Aortic Valve Bioprostheses: A Statewide Experience.

Alexander A Brescia, G Michael Deeb, Stephane Leung Wai Sang, Daizo Tanaka, P Michael Grossman, Devraj Sukul, Chang He, Patricia F Theurer, Melissa Clark, Francis L Shannon and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular interventions, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Managing Transcatheter Aortic Valve Failure.Structural heart : the journal of the Heart Team · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. Surgical Explant of Degenerated Transcatheter Valves: A New Type of Threat?Interdisciplinary cardiovascular and thoracic surgery · 2026
    Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Redo-TAVI with the SAPIEN 3 valve in degenerated calcified CoreValve/Evolut explants.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Alexander A BresciaDepartment of Cardiac Surgery (A.A.B., G.M.D., S.F.), University of Michigan, Ann Arbor.
G Michael DeebDepartment of Cardiac Surgery (A.A.B., G.M.D., S.F.), University of Michigan, Ann Arbor.
Stephane Leung Wai SangMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor (G.M.D., S.L.W.S., D.T., C.H., P.F.T., M.C., F.L.S., S.F.).
Daizo TanakaMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor (G.M.D., S.L.W.S., D.T., C.H., P.F.T., M.C., F.L.S., S.F.).
P Michael GrossmanDepartment of Internal Medicine (P.M.G., D.S., S.J.C.), University of Michigan, Ann Arbor.
Devraj SukulDepartment of Internal Medicine (P.M.G., D.S., S.J.C.), University of Michigan, Ann Arbor.
Chang HeMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor (G.M.D., S.L.W.S., D.T., C.H., P.F.T., M.C., F.L.S., S.F.).
Patricia F TheurerMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor (G.M.D., S.L.W.S., D.T., C.H., P.F.T., M.C., F.L.S., S.F.).
Melissa ClarkMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor (G.M.D., S.L.W.S., D.T., C.H., P.F.T., M.C., F.L.S., S.F.).
Francis L ShannonMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor (G.M.D., S.L.W.S., D.T., C.H., P.F.T., M.C., F.L.S., S.F.).
Stanley J ChetcutiDepartment of Internal Medicine (P.M.G., D.S., S.J.C.), University of Michigan, Ann Arbor.
Shinichi FukuharaDepartment of Cardiac Surgery (A.A.B., G.M.D., S.F.), University of Michigan, Ann Arbor.
Michigan Society of Thoracic and Cardiovascular Surgeons and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

Funding

Vascular Surgery: Research Training in Vascular BiologyT32HL076123 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HENKE, PETER K, WAKEFIELD, THOMAS WILLIAM · 2004 to 2019
$1.9M
NHLBI NIH HHS T32 HL076123
6 · The paper itself

Abstract

backgroundDespite the rapid adoption of transcatheter aortic valve replacement (TAVR) since its initial approval in 2011, the frequency and outcomes of surgical explantation of TAVR devices (TAVR-explant) is poorly understood.

methodsPatients undergoing TAVR-explant between January 2012 and June 2020 at 33 hospitals in Michigan were identified in the Society of Thoracic Surgeons Database and linked to index TAVR data from the Transcatheter Valve Therapy Registry through a statewide quality collaborative. The primary outcome was operative mortality. Indications for TAVR-explant, contraindications to redo TAVR, operative data, and outcomes were collected from Society of Thoracic Surgeons and Transcatheter Valve Therapy databases. Baseline Society of Thoracic Surgeons Predicted Risk of Mortality was compared between index TAVR and TAVR-explant.

resultsTwenty-four surgeons at 12 hospitals performed TAVR-explants in 46 patients (median age, 73). The frequency of TAVR-explant was 0.4%, and the number of explants increased annually. Median time to TAVR-explant was 139 days and among known device types explanted, most were self-expanding valves (29/41, 71%). Common indications for TAVR-explant were procedure-related failure (35%), paravalvular leak (28%), and need for other cardiac surgery (26%). Contraindications to redo TAVR included need for other cardiac surgery (28%), unsuitable noncoronary anatomy (13%), coronary obstruction (11%), and endocarditis (11%). Overall, 65% (30/46) of patients underwent concomitant procedures, including aortic repair/replacement in 33% (n=15), mitral surgery in 22% (n=10), and coronary artery bypass grafting in 16% (n=7). The median Society of Thoracic Surgeons Predicted Risk of Mortality was 4.2% at index TAVR and 9.3% at TAVR-explant (P=0.001). Operative mortality was 20% (9/46) and 76% (35/46) of patients had in-hospital complications. Of patients alive at discharge, 37% (17/37) were discharged home and overall 3-month survival was 73±14%.

conclusionsTAVR-explant is rare but increasing, and its clinical impact is substantial. As the utilization of TAVR expands into younger and lower-risk patients, providers should consider the potential for future TAVR-explant during selection of an initial valve strategy.

Indexed as

Aortic Valve StenosisBioprosthesisHeart Valve ProsthesisTranscatheter Aortic Valve ReplacementAgedAortic ValveHumansRegistriesRisk FactorsTreatment Outcomeaortic valveaortic valve insufficiencyaortic valve stenosiscardiac surgical proceduresMichiganreoperationtranscatheter aortic valve replacement

Identifiers

PMID33719506
PMCPMC8058275

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.