{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:10Z","timestamp":1787018110389,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Valve\u2010in\u2010valve transcatheter aortic valve replacement (TAVR) is a recognized alternative for treating the structural valve deterioration of bioprosthetic valves. Recent guidelines and trials have expanded the indications for TAVR to include younger patients with structural valve deterioration. In this study, we aimed to examine the outcomes of valve\u2010in\u2010valve TAVR across different age groups to understand the age\u2010related clinical outcomes of treating structural valve deterioration following surgical aortic valve replacement and TAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this retrospective study, we included patients who underwent valve\u2010in\u2010valve TAVR at our center. We compared procedural complications and clinical outcomes among patients &lt;75\u2009years of age (n=99), those 75 to 84\u2009years of age (n=103), and those \u226585\u2009years of age (n=71). Echocardiography and computed tomography were used for follow\u2010up evaluations. This study included 273 patients and revealed a low in\u2010hospital complication rate across all age groups. Although the 3\u2010year risk of all\u2010cause mortality was higher in patients &gt;85\u2009years of age, no significant differences in the incidence of stroke\/transient ischemic attack were observed among age groups. All groups exhibited significant improvements in valve hemodynamics that persisted for 3\u2009years. Although leaflet thrombosis assessed using computed tomography imaging 30\u2009days post\u2010TAVR was more prevalent in the older group, age was not an independent predictor of this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Valve\u2010in\u2010valve TAVR was associated with an increased 3\u2010year mortality risk among older patients despite consistent hemodynamic benefits across all age groups. Age\u2010related differences in leaflet thrombosis did not predict hypoattenuated leaflet thickening, indicating that further studies are necessary to elucidate its implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.037168","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T06:22:07Z","timestamp":1739514127000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Age\u2010Related Outcomes of Valve\u2010in\u2010Valve Transcatheter Aortic Valve Replacement for Structural Valve Deterioration"],"prefix":"10.1161","volume":"14","author":[{"given":"Takashi","family":"Nagasaka","sequence":"first","affiliation":[{"name":"Cedars\u2010Sinai Medical Center Smidt Heart Institute Los Angeles CA USA"},{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Maebashi, Gunma 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Gunma University Graduate School of Medicine Maebashi, Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8397-9431","authenticated-orcid":false,"given":"Hasan","family":"Jilaihawi","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center Smidt Heart Institute Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5586-3880","authenticated-orcid":false,"given":"Mamoo","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center Smidt Heart Institute Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj R.","family":"Makkar","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center Smidt Heart Institute Los Angeles CA 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