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Purpose: Transcatheter valve-in-valve implantation is a feasible treatment for patients with failing cardiac bioprostheses who have increased operative risk. The study aimed to compare the outcome of this therapy with redo cardiac surgery.Methods: The study compared the survival of patients with failing cardiac bioprostheses or mitral valve annuloplasty treated with transcatheter valve-in-valve with high risk patients who underwent redo cardiac surgery in a single institution.Results: Overall 16 patients (age 80±2 years, 25% male) underwent transcatheter valve-in-valve procedure and 16 patients (age 70±1 years, 50% male) redo valve surgery. The valve in valve treated group was comparable with surgery treated group with respect to logistic Euroscore (34.1±14.6% vs. 30.8±20.3% p=0.605), New York Heart Association functional class (≥III: 9 (56%) vs. ≥III 7 (44%), p=1.000) and left ventricular ejection fraction (37% (27-52) vs. 40% (26-57), p=0.724). After a median follow up of 21 (7-44) months, overall 10 (30%) patients died. One-year survival of patients treated with valve-in-valve did not differ from those treated with redo surgery (75% vs. 72%, respectively; log-rank p=0.939).Conclusion: Patients with failing cardiac bioprostheses and high operative risk treated with transcatheter valve-in-valve have similar survival compared to high risk patients undergoing redo cardiac surgery.

Fate of transcatheter valve-in-valve implantation and redo cardiac surgery for failing bioprosthetic valves in patients with high operative risk