{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:39:34Z","timestamp":1792442374431,"version":"4.5.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:sec id=\"jah310981-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Redo surgical aortic valve replacement (rSAVR) has for long been the therapeutic reference standard for degenerated surgical aortic bioprostheses. Valve\u2010in\u2010valve transcatheter aortic valve replacement (ViV\u2010TAVR) has emerged as an alternative for patients at high surgical risk due to its lower invasiveness. The long\u2010term clinical efficacy of ViV\u2010TAVR in patients at low to intermediate surgical risk remains unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310981-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              To compare clinical outcomes of redo surgical aortic valve replacement versus ViV\u2010TAVR in low\u2010 to intermediate\u2010risk patients with degenerated surgical aortic bioprostheses. REPEAT (Repeat Intervention for\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">Deteriorated<\/jats:styled-content>\n              Surgical\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">Bioprosthetic Aortic<\/jats:styled-content>\n              Valves) is an investigator\u2010initiated, international, multicenter, randomized, parallel, open\u2010label trial. A total of 890 patients aged &lt;75\u2009years with a failed surgical aortic bioprosthesis due to structural valve degeneration and low to intermediate surgical risk (ie, Society of Thoracic Surgeons predicted risk of death of &lt;8%) will be randomly assigned in a 1:1 ratio to either redo surgical aortic valve replacement or ViV\u2010TAVR.\n            <\/jats:p>\n            <jats:p xml:lang=\"en\">The primary end point of REPEAT is a composite of all\u2010cause death, stroke (including both disabling and nondisabling), myocardial infarction, and rehospitalization for heart failure or aortic valve reintervention at 5\u2009years, based on Valve Academic Research Consortium\u20103 definitions. Secondary end points include each of the individual components of the primary composite end point, Valve Academic Research Consortium\u20103\u2013based conduction disturbances and arrhythmia, Valve Academic Research Consortium\u20103\u2013based wound and bleeding complications, functional status (ie, 6\u2010minute walk test, Kansas City Cardiomyopathy questionnaire), and treatment costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310981-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The REPEAT trial has been designed to test the hypothesis that redo surgical aortic valve replacement is superior to ViV\u2010TAVR regarding clinical outcomes at 5\u2009years in patients with degenerated surgical aortic bioprostheses and low to intermediate surgical risk.<\/jats:p>\n          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