{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:20:51Z","timestamp":1786980051588,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Deutsches Herzzentrum M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Heart Vessels"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Given the recent surge in transcatheter heart valve replacement (THVR), cardiac surgeons will surely face the challenge of eventual explantation. The aim of this study was to determine indications for reoperation, while exploring pertinent technical aspects and survival after THV explantation in a cohort originally deemed high risk or even inoperable. Between February 2008 and March 2019, 31 patients with failed transcatheter aortic valve replacement (TAVR) underwent surgical explantations at our facility. Data were prospectively collected for retrospective analysis of procedural indications, technical issues, and postoperative survival. The major reason for TAVR removal was bioprosthetic valve failure (BVF) due to infective endocarditis (IE: 16\/31 [51.6%]), non-structural (NSVD: 14\/31 [45.2%]) and structural (SVD: 1\/31 [3.2%]) valve deterioration accounting for the rest. Mean age at THV explantation was 76.3\u2009\u00b1\u20098.3\u00a0years, and median time from TAVR to explantation was 153\u00a0days (0\u00a0days\u201356.6\u00a0months). Median ICU and hospital stay were 6\u00a0days (1\u201344\u00a0days) and 23\u00a0days (8\u201362\u00a0days), respectively. Thirty-day and 1-year survival rates were 74.2% and 67.2%, respectively. Median follow-up interval after explantation was 364\u00a0days (3\u00a0days\u201380\u00a0months). Mean cardiopulmonary bypass time was 124.6\u2009\u00b1\u200946.8\u00a0min, and mean aortic cross-clamp time was 84.3\u2009\u00b1\u200932.9\u00a0min. There was no need for unplanned aortic root repair owing to tissue damage during dissection of the TAVR from surrounding tissue. The most common reason for THV explantation was (a) BVF for IE and (b) BVF secondary to NSVD. Although 30-day and 1-year mortality rates in this multimorbid cohort were predictably high, no procedural mortalities occurred.<\/jats:p>","DOI":"10.1007\/s00380-022-02119-7","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T01:02:21Z","timestamp":1657242141000},"page":"2083-2092","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical explantation of failed transcatheter heart valves: indications and results"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0506-1246","authenticated-orcid":false,"given":"Andrea","family":"Muensterer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazan","family":"Puluca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Ruge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keti","family":"Vitanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruediger","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"issue":"25","key":"2119_CR1","doi-asserted-by":"publisher","first-page":"e1159","DOI":"10.1161\/CIR.0000000000000503","volume":"135","author":"RA Nishimura","year":"2017","unstructured":"Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O\u2019Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A (2017) 2017 AHA\/ACC focused update of the 2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines. 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Dr. Ruge received consulting fees from Medtronic. The remaining authors have no disclosures to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the local ethics committee (755\/20 S-SR) and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}