{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:44:54Z","timestamp":1783579494420,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV treated by means of a second TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40\u2009000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III\/IV at presentation was 73.5%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III\/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III\/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04500964.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.120.010440","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T09:05:43Z","timestamp":1623056743000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project"],"prefix":"10.1161","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct04500964","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4687-3686","authenticated-orcid":true,"given":"Luca","family":"Testa","sequence":"first","affiliation":[{"name":"IRCCS Policlinico S. Donato, Milan, Italy (L.T., M.A., N.B., A.P.R., M.C., F.D.M., G.B., F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Agnifili","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico S. Donato, Milan, Italy (L.T., M.A., N.B., A.P.R., M.C., F.D.M., G.B., F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2732-1205","authenticated-orcid":true,"given":"Nicolas M.","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center, Rotterdam, the Netherlands (N.M.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Tch\u00e9tch\u00e9","sequence":"additional","affiliation":[{"name":"Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France (D.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7308-2332","authenticated-orcid":true,"given":"Anita W.","family":"Asgar","sequence":"additional","affiliation":[{"name":"Montreal Heart Institute, Canada (A.W.A., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9674-0278","authenticated-orcid":true,"given":"Ole","family":"De Backer","sequence":"additional","affiliation":[{"name":"Rigshospitalet, Copenhagen University Hospital, Denmark (O.D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-343X","authenticated-orcid":true,"given":"Azeem","family":"Latib","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, New York (A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9890-5582","authenticated-orcid":true,"given":"Bernhard","family":"Reimers","sequence":"additional","affiliation":[{"name":"Humanitas Research Center, IRCCS, Rozzano\u2014Milan, Italy (B.R., G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-6967","authenticated-orcid":true,"given":"Giulio","family":"Stefanini","sequence":"additional","affiliation":[{"name":"Humanitas Research Center, IRCCS, Rozzano\u2014Milan, Italy (B.R., G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Trani","sequence":"additional","affiliation":[{"name":"Policlinico Universitario A. Gemelli, Rome, Italy (C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-2455","authenticated-orcid":true,"given":"Antonio","family":"Colombo","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.C., F.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giannini","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.C., F.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Bartorelli","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS, Milan, Italy (A.B.)."},{"name":"Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d, University of Milan, Italy (A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3681-5207","authenticated-orcid":true,"given":"Wojtek","family":"Wojakowski","sequence":"additional","affiliation":[{"name":"Medical University of Silesia, Katowice, Poland (W.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4496-5950","authenticated-orcid":true,"given":"Maciej","family":"Dabrowski","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland (M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5326-8866","authenticated-orcid":true,"given":"Dariusz","family":"Jagielak","sequence":"additional","affiliation":[{"name":"Medical University, Gda\u0144sk, Poland (D.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2842-7861","authenticated-orcid":true,"given":"Adrian P.","family":"Banning","sequence":"additional","affiliation":[{"name":"John Radcliffe Hospital, Oxford, United Kingdom (A.P.B., R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Kharbanda","sequence":"additional","affiliation":[{"name":"John Radcliffe Hospital, Oxford, United Kingdom (A.P.B., R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Moreno","sequence":"additional","affiliation":[{"name":"Hospital La Paz, IdiPAZ, CIBER-CV, Madrid, Spain (R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Schofer","sequence":"additional","affiliation":[{"name":"MVZ Department Structural Heart Disease at St. Georg, Hamburg, Germany (J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6136-8640","authenticated-orcid":true,"given":"Niels","family":"van Royen","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Nijmegen, the Netherlands (N.v.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duane","family":"Pinto","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Boston, MA (D.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4641-1879","authenticated-orcid":true,"given":"Antoni","family":"Serra","sequence":"additional","affiliation":[{"name":"Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (A. Serra)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Segev","sequence":"additional","affiliation":[{"name":"The Heart and Vascular Center, Chaim Sheba Medical Center, Israel (A. Segev)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Pineta Grande Hospital, Caserta, Italy (A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nedy","family":"Brambilla","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico S. Donato, Milan, Italy (L.T., M.A., N.B., A.P.R., M.C., F.D.M., G.B., F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2451-4626","authenticated-orcid":true,"given":"Antonio","family":"Popolo Rubbio","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico S. Donato, Milan, Italy (L.T., M.A., N.B., A.P.R., M.C., F.D.M., G.B., F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1998-6370","authenticated-orcid":true,"given":"Matteo","family":"Casenghi","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico S. Donato, Milan, Italy (L.T., M.A., N.B., A.P.R., M.C., F.D.M., G.B., F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Oreglia","sequence":"additional","affiliation":[{"name":"Niguarda Ca Granda Hospital, Milan, Italy (J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3554-6938","authenticated-orcid":true,"given":"Federico","family":"De Marco","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico S. 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