{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:00:14Z","timestamp":1788919214784,"version":"build-2803163510"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Data on long-term outcomes after valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) are scarce. The objective of this study was to determine the long-term clinical outcomes and structural valve degeneration (SVD) over time in patients undergoing ViV-TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              Consecutive patients undergoing ViV-TAVR in 9 centers between 2009 and 2015 were included. Patients were followed yearly, and clinical and echocardiography data were collected prospectively. SVD was defined as subclinical (increase &gt;10 mm\u2009Hg in mean transvalvular gradient+decrease &gt;0.3 cm\n              <jats:sup>2<\/jats:sup>\n              in valve area or new-onset mild or moderate aortic regurgitation) and clinically relevant (increase &gt;20 mm\u2009Hg in mean transvalvular gradient+decrease &gt;0.6 cm\n              <jats:sup>2<\/jats:sup>\n              in valve area or new-onset moderate-to-severe aortic regurgitation). A total of 116 patients (mean age, 76\u00b111 years; 64.7% male; mean Society of Thoracic Surgeons score, 8.0\u00b15.1%) were included. Balloon- and self-expandable valves were used in 47.9% and 52.1% of patients, respectively, and 30-day mortality was 6.9%. At a median follow-up of 3 years (range, 2\u20137 years), 30 patients (25.9%) had died, 20 of them (17.2%) from cardiovascular causes. Average mean transvalvular gradients remained stable up to 5-year follow-up (\n              <jats:italic>P<\/jats:italic>\n              =0.92), but clinically relevant SVD occurred in 3\/99 patients (3.0%), and 15\/99 patients (15.1%) had subclinical SVD. One patient with SVD had redo ViV-TAVR.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>About one-fourth of ViV-TAVR recipients had died after a median follow-up of 3 years. Overall valve hemodynamics remained stable over time and clinically relevant SVD was infrequent, but 1 out of 10 patients exhibited some degree of SVD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.118.007038","type":"journal-article","created":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T05:41:01Z","timestamp":1537076461000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Long-Term Outcomes After Transcatheter Aortic Valve-in-Valve Replacement"],"prefix":"10.1161","volume":"11","author":[{"given":"Leonardo","family":"de Freitas Campos Guimar\u00e3es","sequence":"first","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Canada (L.d.F.C.G., J.-M.P., E.D., P.P., J.R.-C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Urena","sequence":"additional","affiliation":[{"name":"Bichat-Claude Bernard University Hospital, Paris, France (M.U., Q.F., D.H.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harindra C.","family":"Wijeysundera","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre (H.C.W.), University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Munoz-Garcia","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen de la Victoria, Malaga, Spain (A.M.-G.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicen\u00e7","family":"Serra","sequence":"additional","affiliation":[{"name":"Hospital Universitario Vall d\u2019Hebron, Barcelona, Spain (V.S., B.G.d.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Benitez","sequence":"additional","affiliation":[{"name":"Clinica de Occidente de Cali, Valle del Cauca, Colombia (L.M.B., 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