Sava Ruxandra I, Garot Philippe, Benamer Hakim, Gall Emmanuel, Pezel Théo, Djebbar Morad, Sayah Neila, Meier David, Tzimas Georgios, Garot Jérôme, Leclercq Florence, Akodad Mariama
Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France.
Department of Cardiology, University Hospital of Lariboisiere, (Assistance Publique des Hôpitaux de Paris, AP-HP), Université Paris-Cité, 75013 Paris, France.
J Clin Med. 2025 Apr 17;14(8):2770. doi: 10.3390/jcm14082770.
With recent guidelines expanding transcatheter aortic valve replacement (TAVR) to younger patients, indications for redo-TAVR will also likely increase. When compared with TAVR, redo-TAVR is a rare and novel procedure. Current clinical data derived from registries suggest excellent safety, with low rates of 30-day and 1-year mortality following redo-TAVR. Proper understanding of data from bench studies regarding optimal valve configurations, of patient anatomy and of the technical properties of transcatheter heart valves (THV) is essential for patient selection and procedural success. Lifetime management of redo-TAVR should start before the index procedure, as the choice of the index THV has a major impact on the feasibility of redo-TAVR. Procedural optimization by adequate valve sizing, commissural alignment and adequate implant depth of both index and redo-THV are critical determinants of optimal hemodynamics for maximized valve longevity, as well as lifelong coronary access.
随着近期指南将经导管主动脉瓣置换术（TAVR）扩展至更年轻的患者，再次TAVR的适应证也可能会增加。与TAVR相比，再次TAVR是一种罕见且新颖的手术。来自注册研究的当前临床数据表明其安全性良好，再次TAVR后的30天和1年死亡率较低。正确理解关于最佳瓣膜构型、患者解剖结构以及经导管心脏瓣膜（THV）技术特性的体外研究数据对于患者选择和手术成功至关重要。再次TAVR的终身管理应在初次手术前就开始，因为初次THV的选择对再次TAVR的可行性有重大影响。通过适当的瓣膜尺寸选择、瓣叶对合以及初次和再次THV的适当植入深度进行手术优化，是实现最佳血流动力学以最大化瓣膜寿命以及终身冠状动脉通路的关键决定因素。
