{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:39:45Z","timestamp":1792445985779,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe real-world treatment allocation and observed long-term survival in patients aged 50 to\u2009&lt;\u200975\u00a0years with failed surgical aortic bioprostheses who underwent reintervention through valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) or redo surgical aortic valve replacement (redo-SAVR) in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged 50 to\u2009&lt;\u200975\u00a0years who underwent ViV-TAVI or redo-SAVR for a failing surgical bioprosthesis between 2015 and 2020 were identified from the Netherlands Heart Registration. Baseline characteristics and Dutch surgical-risk categories were compared by treatment strategy. Multivariable logistic regression was used to identify factors associated with ViV-TAVI selection. Kaplan\u2013Meier analysis described survival, and treatment-specific Cox models explored factors associated with all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 345 patients, 41% underwent ViV-TAVI and 59% redo-SAVR. Patients selected for ViV-TAVI were older (median 71 vs. 67\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), had higher surgical risk (EuroSCORE II: 6.2% vs. 4.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), and had a greater comorbidity burden than redo-SAVR patients. Despite these baseline risk differences, estimated survival within the ViV-TAVI cohort was 94.2% at 30 days, 89.6% at 2 years, and 74.4% at 4 years; corresponding redo-SAVR estimates were 96.1%, 89.8%, and 88.4%. Left ventricular ejection fraction\u2009\u2264\u200930% and chronic lung disease were associated both with ViV-TAVI selection (OR: 8.04, 95% CI: 2.16\u201329.92 and OR: 3.25, 95% CI: 1.53\u20136.92, respectively) and with all-cause mortality\u00a0after redo-SAVR (HR: 15.70, 95% CI: 2.49\u201367.14 and HR: 4.23, 95% CI: 1.53\u201313.14, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this Dutch observational registry, ViV-TAVI was predominantly selected for patients with a higher-risk clinical phenotype, while redo-SAVR was more often used in lower-risk reintervention candidates and showed higher observed long-term survival. These data describe contemporary treatment selection and prognosis but do not establish comparative superiority of either strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-03045-8","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T08:53:43Z","timestamp":1792400023000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment selection and long-term survival in patients aged 50 to\u2009&lt;\u200975\u00a0years undergoing valve reintervention for failed surgical aortic bioprostheses: insights from the Netherlands Heart Registration"],"prefix":"10.1007","author":[{"given":"Antigone","family":"Kostea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"van Niekerk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Uchoa de Assis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"Adrichem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijke J. 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The study was exempt from the Dutch Medical Research Involving Human Subjects Act (WMO).","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr Nuis has received grant support and\/or honoraria from Abbott, Boston Scientific, Meril Lifesciences, Edwards Lifesciences, Sanofi, and AstraZeneca. Dr Van Mieghem has received research grants from Abbott Laboratories, Boston Scientific, Medtronic, Meril, Pie Medical, PulseCath, and Teleflex and is a consultant for Abbott Laboratories, Abiomed, Adjust Medical, Alleviant Medical, AnchorValve, Anteris, Approxima, Boston Scientific, Daiichi-Sankyo, Haemonetics, LUMA Vision, Materialise, Medtronic, Percassist, Pie Medical, Polares, PulseCath, Secure Closure, Supira Medical, Siemens, and Vivasure. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}