{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:33:58Z","timestamp":1784111638176,"version":"3.55.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Transcatheter aortic valve replacement (TAVR) represents a valid treatment for patients with aortic valve stenosis and high or intermediate surgical risk. However, biological transcatheter valves can also experience a structural degeneration after years, and a redo-TAVR procedure (TAVR-in-TAVR) can be a valid option. We revised the current available literature for indications, procedural and technical details and outcome on TAVR-in-TAVR procedures for degenerated TAVR valves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A systematic search was conducted in the public medical database for scientific articles on TAVR-in-TAVR procedures for degenerated transcatheter valves. Data on demographics, indications, first and second transcatheter valve type and size, mortality, complications and follow-up were extracted and analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 13 studies (1 multicentre, 3 case series, 9 case reports) were included in this review, with a total amount of 160 patients treated with TAVR-in-TAVR procedures for transcatheter valve failure. The mean age was 74.8\u2009\u00b1\u20097.8 with 84 males (52.8%). The mean elapsed time from the first TAVR procedure was 58.1\u2009\u00b1\u200923.4\u2009months. Main indication for TAVR-in-TAVR was pure stenosis (38.4%, with mean gradient of 44.5\u2009\u00b1\u200918.5\u2009mmHg), regurgitation (31.4%), mixed stenosis and regurgitation (29.5%) and leaflet thrombosis (8.8%). Procedural success rate was 86.8%, with second TAVR valve malposition occurred in 4 cases (2.5%). The hospital mortality rate was 1.25% (2\/160). Post-procedural echocardiographic control showed moderate regurgitation in 5.6% of patients (9\/160) and residual transvalvular mean gradient \u226520\u2009mmHg in 5% of cases. Postoperative complications included major vascular complications (8.7%), new pacemaker implantation (8.7%), acute kidney failure (3.7%), stroke (0.6%) and coronary obstruction (0.6%). The mean follow-up time was 6\u2009\u00b1\u20095.6\u2009months with 1 non-cardiovascular death reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>TAVR-in-TAVR represents a valid alternative to standard surgery for the treatment of degenerated transcatheter valves in high-risk patients. Despite these promising results, further studies are required to assess durability and haemodynamic performances of the second TAVR valve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab443","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T15:07:02Z","timestamp":1633878422000},"page":"967-976","source":"Crossref","is-referenced-by-count":20,"title":["Transcatheter aortic valve replacement for structural degeneration of previously implanted transcatheter valves (TAVR-in-TAVR): a systematic review"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1392-4558","authenticated-orcid":false,"given":"Michele","family":"Gallo","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Cardiocentro Ticino Institute, Lugano, Switzerland"},{"name":"Department of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5823-2088","authenticated-orcid":false,"given":"Luca Nai","family":"Fovino","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3785-5470","authenticated-orcid":false,"given":"David","family":"Blitzer","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4128-7111","authenticated-orcid":false,"given":"Ilias P","family":"Doulamis","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvise","family":"Guariento","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loris","family":"Salvador","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula","family":"Tagliari","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, 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