{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:46:06Z","timestamp":1791945966939,"version":"4.3.4"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Bioprosthetic mitral valve degeneration is traditionally treated with redo surgical mitral valve replacement (redo\u2010SMVR), but valve\u2010in\u2010valve transcatheter mitral valve replacement (ViV\u2010TMVR) offers a less invasive alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Systematic review and meta\u2010analysis of studies comparing ViV\u2010TMVR and redo\u2010SMVR. PubMed\/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Meta\u2010analyses were conducted with random\u2010effects models to assess patient\u2010relevant outcomes; Kaplan\u2013Meier\u2010derived time\u2010to\u2010event data were pooled to assess late outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Thirteen observational studies met our eligibility criteria, including 15\u2009941 patients (ViV\u2010TMVR: 5465; redo\u2010SMVR: 10476). In comparison with redo\u2010SMVR, ViV\u2010TMVR was associated with lower risk of in\u2010hospital mortality (risk ratio [RR], 0.72 [95% CI, 0.57\u20130.90];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.004), stroke (RR, 0.49 [95% CI, 0.29\u20130.83];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.008), bleeding (RR, 0.43 [95% CI, 0.20\u20130.94];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.035), acute kidney injury (RR, 0.57 [95% CI, 0.42\u20130.77];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), permanent pacemaker implantation (RR, 0.30 [95% CI, 0.19\u20130.49];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and shorter hospital length of stay (mean difference,\u22125.09\u2009days [95% CI, \u22126.56 to \u22123.63];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). There was no statistically significant difference between the groups in terms of 5\u2010year survival (hazard ratio [HR], 0.92 [95% CI, 0.81\u20131.05];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.256); however, the landmark analysis revealed that ViV\u2010TMVR was associated with lower risk of death in the initial 6 months (HR, 0.69 [95% CI, 0.58\u20130.83];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) but a higher risk beyond 6 months (HR, 1.47 [95% CI, 1.20\u20131.79];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients amenable to ViV\u2010TMVR, this procedure shows a lower initial risk of death and complications, but higher mortality after 6\u2009months in comparison with redo\u2010SMVR. These findings highlight the importance of striking a balance between upfront surgical risk and estimated life expectancy when selecting interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.050299","type":"journal-article","created":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T20:52:55Z","timestamp":1777841575000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Valve\u2010in\u2010Valve Transcatheter Mitral Valve Replacement Versus Redo Surgical Mitral Valve Replacement: Meta\u2010Analysis of Early and Late Outcomes"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2996","authenticated-orcid":false,"given":"Michel Pompeu","family":"S\u00e1","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida","place":["Weston, 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