ArticleAnnals of cardiothoracic surgery2025
The current state of transcatheter aortic valve replacement explant: an updated systematic review.
Article in Annals of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- TAVR Explant in the Era of Lifetime Valve Management: Indications, Operative Challenges, and Contemporary Outcomes.Current cardiology reports · 2026Review
- Impact of surgical timing on outcomes after transcatheter aortic valve explantation: insights from a French multicenter retrospective study.Journal of cardiothoracic surgery · 2026Observational
- Surgical Explant of Degenerated Transcatheter Valves: A New Type of Threat?Interdisciplinary cardiovascular and thoracic surgery · 2026Review
- Managing the small aortic annulus in the era of increasing transcatheter aortic valve replacement explant surgery.Journal of visualized surgery · 2026Article
- Surgical Aortic Valve Replacement Following Transcatheter Aortic Valve Implantation Degeneration in a Patient with Prior David Procedure: A Case Report.The Thoracic and cardiovascular surgeon reports · 2026Article
- BIO4LIFE-Surgical Aortic Valve Replacement Followed by Valve-in-Valve Transcatheter Aortic Valve Replacement for Lifetime Management of Aortic Valve Disease: Panacea or Fairytale?Journal of the American Heart Association · 2025Article
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9 authors.
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Abstract
Background: Despite ever-growing adoption of transcatheter aortic valve replacement (TAVR) in younger healthier patients, a limited number of studies have described post-TAVR valve reinterventions such as surgical explantation known as "TAVR explant". Methods: We performed a systematic review to characterize the current state of TAVR explant in patients with a failing transcatheter heart valve (THV) using data published by April 30, 2024 in compliance with the PRISMA and MOOSE reporting guidelines. The protocol was registered in PROSPERO (CRD42024529188). Results: Twenty-eight studies met the eligibility criteria. Almost all studies were non-randomized, observational, and retrospective. The incidence of TAVR explant ranged from 0.2% to 2.8% in patients with a mean age of 67.3-79.0 years, and women representing 25.0-47.1% of cases. The mean time between TAVR implant and explant was 17.0-674.9 days, with most studies reporting a mean time <365 days. Whereas the Society of Thoracic Surgeons-Predicted Risk of Mortality (STS-PROM) score at the time of the TAVR implant ranged between 2.6% and 7.7% (with only one study with score >5%), the STS-PROM score at the time of the TAVR explant ranged between 3.9% and 9.9% (with 17 studies with score >5%). Isolated surgical aortic valve replacement (SAVR) happened in 16.2-100% of cases, aortic root replacement was required in 2.6-41.2%, ascending aortic replacement was performed in 3.2-33.3% of cases. Mitral valve repair/replacement was necessary in 11.8-43.5% and tricuspid valve/repair replacement was done in 2.8-25.0%. Stroke rates were between 0.0% and 20.0% with most studies with rates above 4.0%. The 30-day death rate ranged from 4.8% to 50.0% with most studies with mortality rates higher than 10%. Observed-to-expected mortality ratio was higher than 1.0 in almost all the studies that reported this variable. Conclusions: TAVR explant remains a rare event, but its clinical impact is non-negligible. Lifetime management strategies should be adopted in younger lower-risk patients when choosing THVs for the index TAVR.
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