Bleiziffer, SabineSabineBleizifferSimonato, MatheusMatheusSimonatoWebb, John GJohn GWebbRodés-Cabau, JosepJosepRodés-CabauPibarot, PhilippePhilippePibarotKornowski, RanRanKornowskiWindecker, StephanStephanWindeckerErlebach, MagdalenaMagdalenaErlebachDuncan, AlisonAlisonDuncanSeiffert, MoritzMoritzSeiffertUnbehaun, AxelAxelUnbehaunFrerker, ChristianChristianFrerkerConzelmann, LarsLarsConzelmannWijeysundera, HarindraHarindraWijeysunderaKim, Won-KeunWon-KeunKimMontorfano, MatteoMatteoMontorfanoLatib, AzeemAzeemLatibTchetche, DidierDidierTchetcheAllali, AbdelhakimAbdelhakimAllaliAbdel-Wahab, MohamedMohamedAbdel-WahabOrvin, KatiaKatiaOrvinStortecky, StefanStefanStorteckyNissen, HenrikHenrikNissenHolzamer, AndreasAndreasHolzamerUrena, MarinaMarinaUrenaTesta, LucaLucaTestaAgrifoglio, MarcoMarcoAgrifoglioWhisenant, BrianBrianWhisenantSathananthan, JanarthananJanarthananSathananthanNapodano, MassimoMassimoNapodanoLandi, AntonioAntonioLandiFiorina, ClaudiaClaudiaFiorinaZittermann, ArminArminZittermannVeulemans, VerenaVerenaVeulemansSinning, Jan-MalteJan-MalteSinningSaia, FrancescoFrancescoSaiaBrecker, StephenStephenBreckerPresbitero, PatriziaPatriziaPresbiteroDe Backer, OleOleDe BackerSøndergaard, LarsLarsSøndergaardBruschi, GiuseppeGiuseppeBruschiFranco, Luis NombelaLuis NombelaFrancoPetronio, Anna SoniaAnna SoniaPetronioBarbanti, MarcoMarcoBarbantiCerillo, AlfredoAlfredoCerilloSpargias, KonstantinosKonstantinosSpargiasSchofer, JoachimJoachimSchoferCohen, MauricioMauricioCohenMuñoz-Garcia, AntonioAntonioMuñoz-GarciaFinkelstein, ArielArielFinkelsteinAdam, MattiMattiAdamSerra, VicençVicençSerraTeles, Rui CampanteRui CampanteTelesChampagnac, DidierDidierChampagnacIadanza, AlessandroAlessandroIadanzaChodor, PiotrPiotrChodorEggebrecht, HolgerHolgerEggebrechtWelsh, RobertRobertWelshCaixeta, AdrianoAdrianoCaixetaSalizzoni, StefanoStefanoSalizzoniDager, AntonioAntonioDagerAuffret, VincentVincentAuffretCheema, AsimAsimCheemaUbben, TimmTimmUbbenAncona, MarcoMarcoAnconaRudolph, TanjaTanjaRudolphGummert, JanJanGummertTseng, ElaineElaineTsengNoble, StephaneStephaneNobleBunc, MatjazMatjazBuncRoberts, DavidDavidRobertsKass, MalekMalekKassGupta, AnujAnujGuptaLeon, Martin BMartin BLeonDvir, DannyDannyDvir2024-09-022024-09-022020-08-01https://boris-portal.unibe.ch/handle/20.500.12422/37626AIMS Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. METHODS AND RESULTS A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) ≤ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. CONCLUSIONS The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV.enAortic valve-in-valve Reintervention SAPIEN valve Severe prosthesis–patient mismatch TAVR600 - Technology::610 - Medicine & healtharticle10.7892/boris.1474573259240110.1093/eurheartj/ehaa544