{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:10:45Z","timestamp":1791447045709,"version":"4.3.3"},"reference-count":16,"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":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>As transcatheter aortic valve replacement (TAVR) expands to patients with longer life expectancy, the impact of failure mechanisms on outcomes of TAVR-explant and redo-TAVR remains uncertain. We sought to evaluate outcomes of TAVR reintervention based on the failure mechanism of the index transcatheter aortic valve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>From 2009 to 2022, 553 patients from 29 centers in the EXPLANTORREDO-TAVR registry (Explant or Redo Transcatheter Aortic Valve Replacement) underwent TAVR-explant or redo-TAVR for transcatheter aortic valve failure. Patients with endocarditis were excluded. Patients with structural valve deterioration (SVD, N=224 [64.9%]) were compared with those with nonstructural valve dysfunction (NSVD, N=121 [35.1%]), comprising paravalvular leak (86.0%) and prosthesis-patient mismatch (14.0%). Outcomes were assessed at 30 days and 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Mean age was 75.6\u00b19.3 years, with 42% women. There were no differences in reintervention type between groups (redo-TAVR in 58.0% SVD versus 49.6% NSVD; TAVR-explant: 42.0% versus 50.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.14). Compared with NSVD, SVD was the predominant mode of failure in balloon-expandable valves (50.7% versus 24.8%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), had a longer time to reintervention (50.7 versus 5.5 months;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), and favored non\u2013balloon-expandable valves at redo-TAVR (56.9% versus 33.3%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.003). Mortality at 30 days and 1 year did not differ significantly between SVD and NSVD for either redo-TAVR (30 days: 3.2% versus 1.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =1.00; 1 year: 18.0% versus 12.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.47) or TAVR-explant (30 days: 16.3% versus 12.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.63; 1 year: 40.0% versus 29.5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.39). There were also no differences in risk-adjusted 3-year cumulative mortality between groups (redo-TAVR: hazard ratio, 1.30 [95% CI, 0.68\u20132.46],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.43 [ref=NSVD]; TAVR-explant: hazard ratio, 1.24 [95% CI, 0.64\u20132.41];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.53).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>SVD and NSVD failures had distinct valve types and reintervention timing, with SVD having a longer time to TAVR reintervention, but the failure mechanism did not impact reintervention type or clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.125.016068","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T09:00:11Z","timestamp":1776243611000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of TAVR Failure Mechanism on Outcomes After Reintervention: From the EXPLANTORREDO-TAVR Registry"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5548-4119","authenticated-orcid":true,"given":"Bhavanadhar","family":"Penta","sequence":"first","affiliation":[{"name":"Mount Sinai Health System, New York, NY (B.P., G.H.L.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7219-990X","authenticated-orcid":true,"given":"Gilbert H.L.","family":"Tang","sequence":"additional","affiliation":[{"name":"Mount Sinai Health System, New York, NY (B.P., G.H.L.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-558X","authenticated-orcid":true,"given":"Mohamed","family":"Abdel-Wahab","sequence":"additional","affiliation":[{"name":"Leipzig Heart Center, Germany (M.A.-W., P.K., M.M.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1001-8840","authenticated-orcid":true,"given":"Rik","family":"Adrichem","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center, Rotterdam, The Netherlands (R.A., T.W.H., N.M.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-3398","authenticated-orcid":true,"given":"Hasan","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Westchester Medical Center, Valhalla, NY (H.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4950-5432","authenticated-orcid":true,"given":"Martin","family":"Andreas","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Austria (M.A., M.M.)."}],"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":"Northwestern Medicine, Chicago, IL (A.W.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4618-7520","authenticated-orcid":true,"given":"Igor","family":"Belluschi","sequence":"additional","affiliation":[{"name":"San Raffaele University Hospital, Milan, Italy (I.B., P.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Ben-Ali","sequence":"additional","affiliation":[{"name":"Montreal Heart Institute, Quebec, Canada (W.B.-A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver D.","family":"Bhadra","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Germany (O.D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-2788","authenticated-orcid":true,"given":"Anson","family":"Cheung","sequence":"additional","affiliation":[{"name":"St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada (A. 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Michael","family":"DiMaio","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Health, Heart Hospital Plano, TX (J.M.D.M., E.S., M.S., M.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4079-3482","authenticated-orcid":true,"given":"John K.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, CT (J.K.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7898-5159","authenticated-orcid":true,"given":"Shinichi","family":"Fukuhara","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor (S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8943-9962","authenticated-orcid":true,"given":"Arnar","family":"Geirsson","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center, New York, NY (A.G., L.P., T.N.N., M.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-3876","authenticated-orcid":true,"given":"Sachin S.","family":"Goel","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (S.S.G., N.S.K., M.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4994-5219","authenticated-orcid":true,"given":"Joshua B.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical Center\/New York Presbyterian Hospital (J.B.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[{"name":"University Hospital LMU Munich (C.H., S.S.), Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3322-9568","authenticated-orcid":true,"given":"Howard C.","family":"Herrmann","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia (N.D.D., H.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9309-0011","authenticated-orcid":true,"given":"Thijmen W.","family":"Hokken","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center, Rotterdam, The Netherlands (R.A., T.W.H., N.M.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorg","family":"Kempfert","sequence":"additional","affiliation":[{"name":"German Heart Center Berlin, Germany (J.K., A.U.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Leipzig Heart Center, Germany (M.A.-W., P.K., M.M.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-8133","authenticated-orcid":true,"given":"Neal S.","family":"Kleiman","sequence":"additional","affiliation":[{"name":"Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (S.S.G., N.S.K., M.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Kliger","sequence":"additional","affiliation":[{"name":"Lenox Hill Hospital, New York, NY (C.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-4914","authenticated-orcid":true,"given":"Markus","family":"Mach","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Austria (M.A., M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1000-4710","authenticated-orcid":true,"given":"Mateo","family":"Marin-Cuartas","sequence":"additional","affiliation":[{"name":"Leipzig Heart Center, Germany (M.A.-W., P.K., M.M.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5524-5844","authenticated-orcid":true,"given":"David","family":"Meier","sequence":"additional","affiliation":[{"name":"St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada (A. 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